Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Gwenetta J Dickerson

Individual provider Massage Therapist · NPI 1730681800

Gwenetta J Dickerson is a Massage Therapist in Collinsville, Illinois. Practices as a sole proprietor. Licensed in Illinois.

Licensed in
IL
In the registry since
2018
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Practice location Address checks out

100 Eagle Crk
Collinsville, IL 62234-4395
Phone: (314) 933-6369
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Massage Therapist (primary) Taxonomy 225700000X · Licence 227018739 (IL)

Record details

NPI number1730681800
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedMarch 5, 2018
Last updated in NPPESMarch 5, 2018

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