Provider Demographics
NPI:1770768087
Name:DICKINSON, RASHAN JAMILA (OTD, OTR/L)
Entity type:Individual
Prefix:MRS
First Name:RASHAN
Middle Name:JAMILA
Last Name:DICKINSON
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:DR
Other - First Name:RASHAN
Other - Middle Name:JAMILA
Other - Last Name:WHITE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTD, OTR/L
Mailing Address - Street 1:3160 MAIN ST STE 103
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-3461
Mailing Address - Country:US
Mailing Address - Phone:404-955-7202
Mailing Address - Fax:
Practice Address - Street 1:3160 MAIN ST STE 103
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-3461
Practice Address - Country:US
Practice Address - Phone:404-955-7202
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-04
Last Update Date:2024-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119006956225X00000X
GA7595225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist