Edmond Spencer Dibble III

NPI #1639837206 in Farmington, New York

Provider Information

NPI Number: 1639837206
Entity Type: Individual
Name: Edmond Spencer Dibble III
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Peer Specialist
Enumeration Date: Dec 1, 2021
Last Updated: Dec 1, 2021

Practice Location

Address: 1533 MEADOWBROOK LANE
City: Farmington
State: New York
ZIP Code: 14425
Phone: (813) 892-9373

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Peer Specialist	175T00000X	Primary

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