Doctor Name: | DAVID DICH |
NPI Number: | 1215320908 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LPC |
License Number: | 5474-125 |
Business Practice Address: | W62n248 Washington Ave Suite#207 Cedarburg, WI - 530122768 |
Business Phone Number: | 2623750879 |
Business Fax Number: | |
Mailing Address: | W62n248 Washington Ave, Suite#207 CEDARBURG |
State: | WI |
Postal Code: | 530122768 |
Phone Number: | 2623750879 |
Fax Number: | |
NPI Enumeration Date: | 03/05/2015 |
NPI Last Update Date: | 03/05/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 5474-125 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |