Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2251N0400X | Physical Therapist - Neurology | 0551 | NV |
N | 2251P0200X | Physical Therapist - Pediatrics | 0551 | NV |
N | 2251X0800X | Physical Therapist - Orthopedic | 0551 | NV |
NPI | 1417042128 |
---|---|
Provider Name | Ms. Jill Ann Dickinson |
First Address | Washoe Valley, NV 89704-8576 |
Second Address | Washoe Valley, NV 89704-8576 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2006 |
Last Update Date | 09/07/2007 |