| Doctor Name: | MRS. TARA N DICKSON |
| NPI Number: | 1497905988 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | BS |
| License Number: | |
| Business Practice Address: | 90 N 31st St Clinton, OK - 736019116 |
| Business Phone Number: | 5803236021 |
| Business Fax Number: | 5803230828 |
| Mailing Address: | Po Box 66, CANUTE |
| State: | OK |
| Postal Code: | 736260066 |
| Phone Number: | 5803236021 |
| Fax Number: | 5803230828 |
| NPI Enumeration Date: | 09/22/2008 |
| NPI Last Update Date: | 09/22/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101Y00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| 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 |