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GWENETTA J DICKERSON
NPI 1730681800
Massage Therapist in Collinsville, IL

Active since March 05, 2018
100 EAGLE CRK, COLLINSVILLE, IL 62234(314) 933-6369 Get Directions Write a Review

NPPES record last updated: March 5, 2018. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Gwenetta J Dickerson NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GWENETTA J DICKERSON (NPI 1730681800) is an individual massage therapist in Collinsville, Illinois, licensed in Illinois (227018739) and active in the NPI registry since March 2018.

NPPES Registry Identity

NPI1730681800
Entity TypeIndividualFemale
Primary Taxonomy225700000X
Provider Legal NameGWENETTA J DICKERSON
Location Address100 EAGLE CRKCollinsville, IL 62234-4395
Mailing Address100 Eagle CrkCollinsville, IL 62234-4395
Phone(314) 933-6369
Sole ProprietorYes
Enumeration DateMarch 5, 2018
✔ NPI 1730681800 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225700000X
License✔ Licensed in IL · 227018739
Definition

An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.

100 EAGLE CRK, Collinsville, IL 62234
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Gwenetta Dickerson's NPI number?

The NPI number for Gwenetta Dickerson is 1730681800. It was assigned to this individual provider in the NPPES registry on March 5, 2018.

Where is Gwenetta Dickerson located?

Gwenetta Dickerson practices at 100 Eagle Crk, Collinsville, IL 62234. The listed phone number is (314) 933-6369.

What is Gwenetta Dickerson's specialty?

The primary specialty registered for this NPI is Massage Therapist with taxonomy code 225700000X.

When was this NPI record last updated?

The NPPES record for Gwenetta Dickerson was last updated on March 5, 2018. NPI Profile syncs with the weekly NPPES data releases published by CMS.