Thomas Dallin Dickerson

NPI #1023309952 in Provo, Utah

Provider Information

NPI Number: 1023309952
Entity Type: Individual
Name: Thomas Dallin Dickerson
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Counselor
Enumeration Date: Apr 26, 2011
Last Updated: Apr 26, 2011

Practice Location

Address: 717 W 1850 N
City: Provo
State: Utah
ZIP Code: 84604-1416
Phone: (801) 687-1225

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor	101Y00000X	Primary

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