Individual
MRS. GINA LYNN DICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LMHCA, NCACI, CD
Contact information
Practice address
1740 NE RIDDELL RD STE 314, BREMERTON, WA 98310-3693
(360) 373-4077
(360) 792-0362
Mailing address
1740 NE RIDDELL RD STE 314, BREMERTON, WA 98310-3693
(360) 373-4077
(360) 792-0362
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
CG60201203
WA
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP00006322
WA
101YM0800X
Mental Health Counselor
MC60210692
WA
Other
Enumeration date
08/29/2012
Last updated
08/29/2012
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