Individual
MRS. MYTOSHA MONIQUE DICKERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CBS
Contact information
Practice address
9082 WINDING LAKE AVE, BATON ROUGE, LA 70810-0367
(504) 875-6174
Mailing address
9082 WINDING LAKE AVE, BATON ROUGE, LA 70810-0367
(504) 875-6174
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
07/10/2022
Last updated
04/30/2024
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