Doctor Name: | DENISE DICKENS |
NPI Number: | 1215306287 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PLPC |
License Number: | 2015030972 |
Business Practice Address: | 704 Historic 66 W Ste 207 Waynesville, MO - 655832136 |
Business Phone Number: | 5734334846 |
Business Fax Number: | 5734331208 |
Mailing Address: | 1824 Jaden Ct, LEBANON |
State: | MO |
Postal Code: | 655364107 |
Phone Number: | 4177189065 |
Fax Number: | |
NPI Enumeration Date: | 09/21/2015 |
NPI Last Update Date: | 03/23/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | 2015030972 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |