Individual
ADRIANA DICKINSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
110 N 4TH ST., PONCA CITY, OK 74601-4627
(580) 749-5056
Mailing address
110 N 4TH ST., PONCA CITY, OK 74601-4627
(580) 749-5056
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
07/08/2015
Last updated
10/28/2021
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