| Doctor Name: | MR. LANCE F. DICKISON |
| NPI Number: | 1952506370 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LPC NCC |
| License Number: | 3005 |
| Business Practice Address: | 463 Sw 579 Loop Bldg. 'b' Chouteau, OK - 74337 |
| Business Phone Number: | 9184760501 |
| Business Fax Number: | 9182073064 |
| Mailing Address: | 463 Sw 579 Loop, Bldg. 'b' CHOUTEAU |
| State: | OK |
| Postal Code: | 74337 |
| Phone Number: | 9184760501 |
| Fax Number: | 9182073064 |
| NPI Enumeration Date: | 06/16/2007 |
| NPI Last Update Date: | 12/08/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 3005 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | OK |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |