Dickerson, Theresa M

Dickerson, Theresa M is an sole proprietor health care provider with primary practice located at 2625 N Meridian St , Indianapolis IN 46208-7701. She recently has 3 registered licenses in different health care specialties including Other Service Providers / Reflexologist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Specialist/Technologist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Massage Therapist. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Massage Therapist is her primary health care specialty. Dickerson, Theresa M can be contacted via phone (678) 429-3197.

Contact Information

Primary practice address
2625 N Meridian St Indianapolis IN 46208-7701
Phone: (678) 429-3197
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Reflexologist 173C00000X MT20901976 Indiana
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Specialist/Technologist 225500000X MT20901976 Indiana
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Massage Therapist 225700000X MT20901976 Indiana

Profile Details

NPI number 1689982613
LBN Legal business name Dickerson, Theresa M
Credentials LMT, CBW
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 24th, 2010
Last updated Sep 24th, 2010 - about 16 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 1689982613 NPPES
Indiana Other MT20901976 STATE LICENSE

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