Provider Demographics
NPI:1457759334
Name:DICKERMAN, MONICA JOYCE (MOT, OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:MONICA
Middle Name:JOYCE
Last Name:DICKERMAN
Suffix:
Gender:F
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:MONICA
Other - Middle Name:JOYCE
Other - Last Name:GRIECO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:174 VIRGINA AVENUE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:15074
Mailing Address - Country:US
Mailing Address - Phone:724-728-1036
Mailing Address - Fax:
Practice Address - Street 1:174 VIRGINIA AVENUE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:PA
Practice Address - Zip Code:15074
Practice Address - Country:US
Practice Address - Phone:724-728-1340
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC13519225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist