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Individual

TERRI DICKERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CADC

Contact information

Practice address
505 HECKS PLAZA, MOREHEAD, KY 40351
(859) 209-2360
Mailing address
242 TACKETT BOTTOM RD, SALYERSVILLE, KY 41465
(859) 209-2360

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1260
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1260
KY
Enumeration date
10/06/2015
Last updated
10/06/2015
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