Individual
MS. KYOUNG HI SONG DICKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
38 KELLEY ST, BRISTOL, CT 06010-5715
(860) 314-1236
(860) 314-1236
Mailing address
38 KELLEY STREET, BRISTOL, CT 06107
(860) 314-1236
(860) 314-1236
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
001459
CT
Other
Enumeration date
07/13/2011
Last updated
07/13/2011
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