Dickinson, Gary L

Dickinson, Gary L is an sole proprietor health care provider with primary practice located at 2218 Derdall Dr , Brookings SD 57006-2851. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Dickinson, Gary L can be contacted via phone (605) 271-7690.

Contact Information

Primary practice address
2218 Derdall Dr Brookings SD 57006-2851
Phone: (605) 271-7690
Fax: (605) 479-1349
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X 231 South Dakota

Profile Details

NPI number 1093760233
LBN Legal business name Dickinson, Gary L
Credentials PHD
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 24th, 2006
Last updated Feb 29th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1093760233 NPPES
South Dakota MEDICAID 6551103
South Dakota Other 4993550
South Dakota MEDICAID 893248400

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