Provider Demographics
NPI:1417602459
Name:DICKENS, BILLIE CHRISTINE (COTA/L)
Entity Type:Individual
Prefix:MISS
First Name:BILLIE
Middle Name:CHRISTINE
Last Name:DICKENS
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16692 STONEFIELD
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:TX
Mailing Address - Zip Code:77316-2900
Mailing Address - Country:US
Mailing Address - Phone:972-741-3427
Mailing Address - Fax:
Practice Address - Street 1:16692 STONEFIELD
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:TX
Practice Address - Zip Code:77316-2900
Practice Address - Country:US
Practice Address - Phone:972-741-3427
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-17
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX215693225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Single Specialty