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Individual

RETINA A DICK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPCC

Contact information

Practice address
1830 DESTINY LN STE 106, BOWLING GREEN, KY 42104-1088
(270) 904-5195
(270) 904-3648
Mailing address
1830 DESTINY LN STE 106, BOWLING GREEN, KY 42104-1088
(270) 904-5195
(270) 904-3648

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
105644
KY

Other

Enumeration date
03/05/2007
Last updated
12/01/2016
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