Provider Demographics
NPI:1528494176
Name:DICKSON, DARLENE MARIE
Entity type:Individual
Prefix:MRS
First Name:DARLENE
Middle Name:MARIE
Last Name:DICKSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:465 PATRIOTS RD
Mailing Address - Street 2:
Mailing Address - City:TEMPLETON
Mailing Address - State:MA
Mailing Address - Zip Code:01468-1403
Mailing Address - Country:US
Mailing Address - Phone:978-939-4000
Mailing Address - Fax:
Practice Address - Street 1:465 PATRIOTS RD
Practice Address - Street 2:
Practice Address - City:TEMPLETON
Practice Address - State:MA
Practice Address - Zip Code:01468-1403
Practice Address - Country:US
Practice Address - Phone:978-939-4000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-15
Last Update Date:2013-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist