Provider Demographics
NPI:1891484978
Name:DICKSON, SARAH L (BEHAVIOR TECHNICIAN)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:L
Last Name:DICKSON
Suffix:
Gender:F
Credentials:BEHAVIOR TECHNICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:153 LANDER ST
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550-4534
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:118 RIVER RD STE 14
Practice Address - Street 2:
Practice Address - City:HARRIMAN
Practice Address - State:NY
Practice Address - Zip Code:10926-3040
Practice Address - Country:US
Practice Address - Phone:845-863-5208
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-03
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYRBT-22-225411106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician