| Doctor Name: | BRIDGET BAKER DICKSON |
| NPI Number: | 1053657742 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LAC |
| License Number: | 681 |
| Business Practice Address: | 1295 Florida Ave Sw Denham Springs, LA - 707264635 |
| Business Phone Number: | 2252818115 |
| Business Fax Number: | 2252436029 |
| Mailing Address: | 1295 Florida Ave Sw, DENHAM SPRINGS |
| State: | LA |
| Postal Code: | 707264635 |
| Phone Number: | 2252818115 |
| Fax Number: | 2252436029 |
| NPI Enumeration Date: | 12/27/2012 |
| NPI Last Update Date: | 12/27/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 681 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | LA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |