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General NPI Number Information
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NPI Number | 1205785805
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Entity Type | Individual
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Provider Name | HALEY A DICKENS
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Gender | Female
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Dates
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Enumeration Date | 01/26/2026
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Last Update Date | 01/29/2026
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Provider Practice Location Address
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Address Line | 915 N WISE DR
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City | SUMTER
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State | SC
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Zip | 29153-8580
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Country | US
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Telephone | 803-965-9002
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Fax |
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Provider Business Mailing Address
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Address Line | 4100 BROAD ST LOT 35
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City | SUMTER
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State | SC
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Zip | 29154-1612
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Country | US
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Telephone | 803-406-1976
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 6953
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License Number State | SC
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