Provider Demographics
NPI:1427202985
Name:DICKENSON-HARDING, JANE PATRICIA (BS)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:PATRICIA
Last Name:DICKENSON-HARDING
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:88 HECKER AVE
Mailing Address - Street 2:
Mailing Address - City:DARIEN
Mailing Address - State:CT
Mailing Address - Zip Code:06820-5310
Mailing Address - Country:US
Mailing Address - Phone:203-984-9439
Mailing Address - Fax:203-655-3509
Practice Address - Street 1:1193 WARBURTON AVE
Practice Address - Street 2:OT KIDS PLUS OF NY, INC.
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-1002
Practice Address - Country:US
Practice Address - Phone:914-377-8800
Practice Address - Fax:914-377-8700
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-11
Last Update Date:2008-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009215-1252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency