Provider Demographics
NPI:1922758291
Name:DICKEN, CRISTIN SPARKS (MS)
Entity Type:Individual
Prefix:
First Name:CRISTIN
Middle Name:SPARKS
Last Name:DICKEN
Suffix:
Gender:F
Credentials:MS
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Mailing Address - Street 1:12200 PRESTON RD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-2200
Mailing Address - Country:US
Mailing Address - Phone:972-560-2667
Mailing Address - Fax:
Practice Address - Street 1:12200 PRESTON RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-2200
Practice Address - Country:US
Practice Address - Phone:972-560-2667
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-28
Last Update Date:2022-03-28
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Y00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersClinical Exercise Physiologist