Provider Demographics
NPI:1184875452
Name:DICKEY, NANCY JOAN (OTR)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:JOAN
Last Name:DICKEY
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:JOAN
Other - Last Name:BEISSWENGER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4350 S NATIONAL AVE
Mailing Address - Street 2:SUITE B 116
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65810-2607
Mailing Address - Country:US
Mailing Address - Phone:417-881-1282
Mailing Address - Fax:417-881-2840
Practice Address - Street 1:4350 S NATIONAL AVE
Practice Address - Street 2:SUITE B 116
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65810-2607
Practice Address - Country:US
Practice Address - Phone:417-881-1282
Practice Address - Fax:417-881-2840
Is Sole Proprietor?:No
Enumeration Date:2008-10-06
Last Update Date:2008-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO1009225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist