Individual
MR. LEGREGORY JEROME DYKES SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYCHOMETRIST
Contact information
Practice address
1061 HARMON AVE, FORT STEWART, GA 31314-5641
(912) 435-5231
Mailing address
1061 HARMON AVE, FORT STEWART, GA 31314-5641
(912) 435-5231
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
246RP1900X
Phlebotomy Technician
—
GA
Other
Enumeration date
09/03/2014
Last updated
09/10/2014
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