Individual
SAMANTHA RENEE DICKOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
4430 MISSOURI AVE, FORT LEONARD WOOD, MO 65473-9098
(440) 567-6681
Mailing address
4430 MISSOURI AVE, FORT LEONARD WOOD, MO 65473-9098
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
C.1801517
OH
106H00000X
Marriage & Family Therapist
M.1700073-TRNE
OH
Other
Enumeration date
05/15/2018
Last updated
07/03/2023
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