Joanne Elizabeth Dickerson
Individual provider Active NPI Behavior Technician · Debary, FL
NPI 1225857618 · NPPES record last updated Oct 3, 2024
Key facts
- NPI
- 1225857618
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- License
- 24-379910 (FL)
- Practice address
- 454 Fort Florida Rd
Debary, FL 32713-9714 - Phone
- (386) 562-0170
- NPI assigned
- Oct 3, 2024
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24-379910 | FL | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Behavioral Independence | Behavior Technician | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician |
106S00000X | 24-379910 | FL | Yes |
Addresses
Primary practice location
454 Fort Florida Rd
Debary, FL 32713-9714
Mailing address
454 Fort Florida Rd
Debary, FL 32713-9714
Phone (386) 562-0170
Other providers in Debary, FL
- Delta Health Group Inc
- Deltona Counseling Associates, P.a.
- Krista Denoff
- Diabetic Shoe Source Inc.
- Jessica Diaz
- Eileen Marie Dobrinski
- Donna Stapleton
- Richard Allan Dowling
- Deandrea Yvonne Duffus
- Baylee Eads
All providers in Debary, FL · Behavior Technician in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 3, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.