Individual
MRS. TARA N DICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS
Contact information
Practice address
90 N 31ST ST, CLINTON, OK 73601-9116
(580) 323-6021
(580) 323-0828
Mailing address
PO BOX 66, CANUTE, OK 73626-0066
(580) 323-6021
(580) 323-0828
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
09/22/2008
Last updated
09/22/2008
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