Dickinson, Jane

Dickinson, Jane is an individual health care provider with primary practice located at Pvs -1574 St.Rd. 502, Santa Fe NM 87501. She recently has only one registered license in Behavioral Health & Social Service Providers / School, which is considered as her primary health care specialty. Dickinson, Jane can be contacted via phone (505) 455-0801.

Contact Information

Primary practice address
Pvs -1574 St.Rd. 502 Santa Fe NM 87501
Phone: (505) 455-0801
Fax: (505) 455-3023
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / School 103TS0200X 289712 New Mexico

Profile Details

NPI number 1073735064
LBN Legal business name Dickinson, Jane
Credentials NCSP
Entity Individual
Sole proprietor 1 No
Enumeration date May 2nd, 2007
Last updated Jul 8th, 2007 - about 19 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 1073735064 NPPES
New Mexico MEDICAID 09288082

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