NPI 1588991582

Jeremy Lynn Dicicco

Practitioner Rehabilitation Counselor Benton, AR

Practice location

Address: 10 Hyten, Benton, AR 72015-3831
Phone: (804) 592-1205

Registered specialties (2)

Rehabilitation Counselor Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225C00000X

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Mental Health Counselor

Behavioral Health & Social Service Providers Taxonomy 101YM0800X

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Registry record

NPI: 1588991582
Entity type: Individual
Sex (as registered): Male
NPI issued: 11 Nov 2009
Record last updated: 3 Feb 2023

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.