Individual
KATINA DICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA MATC QMHP-A
Contact information
Practice address
999 WATERSIDE DR STE 2525, NORFOLK, VA 23510-3316
(757) 777-3454
Mailing address
1310 COLUMBIA ST, PORTSMOUTH, VA 23704-4003
(757) 358-1359
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
D2005061525
VA
Other
Enumeration date
06/18/2020
Last updated
11/27/2023
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