Most Relevant Information
Provider Data
| NPI Number: | 1003664160 |
| Provider Name: | DIONNE MICKENS |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: |
Most Important Dates
| Enumeration Date: | 05/13/2024 |
| Last Updated: | 05/21/2024 |
Provider Practice Location
129 JOHNSON RD STE 7
TURNERSVILLE
NJ
080121777
Practice Location Phone/Fax
| Phone: | 8562272717 |
| Fax: |
Provider Mailing Location
129 JOHNSON RD STE 7
TURNERSVILLE
NJ
080121777
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |