Individual
JAMIE DYCHE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2020 E 70TH ST STE 201, SHREVEPORT, LA 71105-5332
(318) 751-9098
Mailing address
3516 7TH ST, SACHSE, TX 75048-3882
(318) 423-3441
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
LA
101YP2500X
Professional Counselor
Primary
7570
LA
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
05/16/2018
Last updated
09/21/2020
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