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Individual
MR. LEGREGORY JEROME DYKES SR.
Active
Individual
MR. LEGREGORY JEROME DYKES SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYCHOMETRIST
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
246RP1900X
Phlebotomy Technician
—
GA
Other
Enumeration date
09/03/2014
Last updated
09/10/2014
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