Provider Demographics
NPI:1215161468
Name:BICKEL, DORIS JEAN (BA , MS)
Entity type:Individual
Prefix:MRS
First Name:DORIS
Middle Name:JEAN
Last Name:BICKEL
Suffix:
Gender:F
Credentials:BA , MS
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Mailing Address - Street 1:1115 S 8TH ST
Mailing Address - Street 2:
Mailing Address - City:GOSHEN
Mailing Address - State:IN
Mailing Address - Zip Code:46526-4307
Mailing Address - Country:US
Mailing Address - Phone:574-534-0737
Mailing Address - Fax:574-534-0737
Practice Address - Street 1:1115 S 8TH ST
Practice Address - Street 2:
Practice Address - City:GOSHEN
Practice Address - State:IN
Practice Address - Zip Code:46526-4307
Practice Address - Country:US
Practice Address - Phone:574-534-0737
Practice Address - Fax:574-534-0737
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-02
Last Update Date:2009-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN907788222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist