Provider Demographics
NPI:1457648925
Name:DICKINSON, ROSE ANN (LMSW)
Entity Type:Individual
Prefix:
First Name:ROSE
Middle Name:ANN
Last Name:DICKINSON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 N BUXTON ST RM 117
Mailing Address - Street 2:
Mailing Address - City:INDIANOLA
Mailing Address - State:IA
Mailing Address - Zip Code:50125-2412
Mailing Address - Country:US
Mailing Address - Phone:515-961-1006
Mailing Address - Fax:515-961-1114
Practice Address - Street 1:111 N BUXTON ST RM 117
Practice Address - Street 2:
Practice Address - City:INDIANOLA
Practice Address - State:IA
Practice Address - Zip Code:50125-2412
Practice Address - Country:US
Practice Address - Phone:515-961-1006
Practice Address - Fax:515-961-1114
Is Sole Proprietor?:No
Enumeration Date:2011-07-06
Last Update Date:2011-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical