Individual
KATHY DICKERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
398 E MAIN ST STE 206, TUPELO, MS 38804-4037
(662) 591-1141
Mailing address
949 ROAD 1310, MOOREVILLE, MS 38857-8105
(662) 871-4352
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1172
MS
Other
Enumeration date
03/15/2022
Last updated
03/15/2022
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