Individual
JOHN DICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CIT
Contact information
Practice address
201 W BAYOU ST, FARMERVILLE, LA 71241-2707
(318) 243-3934
Mailing address
451 HENRY SMITH RD, BERNICE, LA 71222-5523
(318) 243-3934
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CIT-5196
LA
Other
Enumeration date
10/29/2020
Last updated
10/29/2020
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