Most Relevant Information
Provider Data
| NPI Number: | 1003439928 |
| Provider Name: | KELLY NICOLE DICKERSON LCSW |
| Entity Type: | Individual |
| Taxonomy Code: | 1041C0700X |
| Specialty: | Social Worker |
| License Number: | CSW007086 |
Most Important Dates
| Enumeration Date: | 05/27/2020 |
| Last Updated: | 07/31/2024 |
Provider Practice Location
204 W SPRING ST
MONROE
GA
306551914
Practice Location Phone/Fax
| Phone: | 7705997508 |
| Fax: | 8667347631 |
Provider Mailing Location
204 W SPRING ST
MONROE
GA
306551914
Provider Mailing Phone/Fax
| Phone: | 7705997508 |
| Fax: | 8667347631 |