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Individual

ANDREW L DICKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 268-5620
(601) 268-5851
Mailing address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 268-5620
(601) 268-5851

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
8104
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00124964
MS
01
1559323
AMERICAN ADMIN GROUP
MS
01
260027218
RAILROAD MEDICARE
Enumeration date
08/03/2006
Last updated
03/26/2009
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