Individual
IDA DICKIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
225 N CLIFTON AVE STE 6, LOUISVILLE, KY 40206-2438
(502) 496-4928
Mailing address
225 N CLIFTON AVE STE 6, LOUISVILLE, KY 40206-2438
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
129121
KY
103TF0200X
Forensic Psychologist
Primary
129121
KY
Other
Enumeration date
05/01/2023
Last updated
02/18/2025
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