Individual provider · Type 1 NPI
Edmond Spencer Dibble Iii
Peer Specialist · Farmington, NY
NPI number
1639837206
Active
Practice location
1533 Meadowbrook Lane
Farmington, NY 14425
Mailing address
835 West Main Street
Rochester, NY 14611
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Peer Specialist Primary | 175T00000X | None listed |
Peer Specialist: Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
About NPI 1639837206
Edmond Spencer Dibble Iii's National Provider Identifier is 1639837206, issued on Dec 1, 2021. The primary taxonomy on file is Peer Specialist (175T00000X), and the practice location is in Farmington, NY. The record was last updated on Dec 1, 2021.