Individual
MARTIN JAMES DYKES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.A.C.
Contact information
Practice address
1513 LINE AVE, SHREVEPORT, LA 71101-4621
(318) 742-5146
Mailing address
1513 LINE AVE, SHREVEPORT, LA 71101-4621
(318) 742-5146
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
736
LA
Other
Enumeration date
08/03/2012
Last updated
03/28/2013
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