Individual
THAD SHANE DICKSON
Active
Individual
THAD SHANE DICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPHIMS, PMP
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
WA
246Z00000X
Other Specialist/Technologist
Primary
CPHIMS - 1592
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1592
CPHIMS
WA
01
—
451268
HCISSP
WA
01
—
DICKSTS PMP
PMP
WA
Enumeration date
06/23/2011
Last updated
05/07/2014
Update your record
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