Individual
NICOLE DICKENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
114 REPRESENTATIVE ROW, SUITE B, LAFAYETTE, LA 70508-3878
(337) 769-7001
Mailing address
114 REPRESENTATIVE ROW, SUITE B, LAFAYETTE, LA 70508-3878
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
13406R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1564079
—
LA
Enumeration date
01/16/2006
Last updated
06/23/2015
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