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Individual
MR. JON DICK
Active
Individual
MR. JON DICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSS. LSW, LICDC-CS
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
965770
OH
101YM0800X
Mental Health Counselor
S1278
OH
Other
Enumeration date
04/01/2016
Last updated
04/01/2016
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