Individual
DR. JOHN AZAR-DICKENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
106 E 5TH AVE, ROME, GA 30161-3128
(706) 232-6743
(706) 232-8050
Mailing address
PO BOX 6206, ROME, GA 30162-6206
(706) 232-6743
(706) 232-8050
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2459
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00895837
—
GA
Enumeration date
12/04/2006
Last updated
07/09/2007
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