Individual
CHRISTINA DISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
617 S TRENTON ST, RUSTON, LA 71270-5040
(318) 251-4659
(318) 251-4659
Mailing address
617 S TRENTON ST, RUSTON, LA 71270-5040
(318) 251-4659
(318) 251-4659
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
11424
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
24680
—
LA
Enumeration date
06/30/2014
Last updated
02/05/2015
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