Individual
CHARLI J DICKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
1833 ACR 463, MONTALBA, TX 75853
(903) 724-1019
Mailing address
1833 ACR 463, MONTALBA, TX 75853
(903) 724-1019
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
312856
TX
Other
Enumeration date
10/12/2020
Last updated
10/12/2020
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