Individual
MARKITA DISMUKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1205 N 18TH ST STE 210, MONROE, LA 71201-5462
(318) 503-8553
Mailing address
920 TAMPA ST, TALLULAH, LA 71282-5040
(318) 341-9880
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
Other
Enumeration date
03/30/2013
Last updated
08/19/2025
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