Provider Demographics
NPI:1750504510
Name:DICKEY, JUDITH ANN (LMFT)
Entity type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:ANN
Last Name:DICKEY
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:MISS
Other - First Name:JUDITH
Other - Middle Name:ANN
Other - Last Name:NICKEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:501 EAST TERRACE AVENUE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93704
Mailing Address - Country:US
Mailing Address - Phone:559-304-3849
Mailing Address - Fax:
Practice Address - Street 1:501 EAST TERRACE AVENUE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93704
Practice Address - Country:US
Practice Address - Phone:559-304-3849
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA24294106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist