Individual
MARDELL DICKINSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1716 UNIVERSITY AVE S, FAIRBANKS, AK 99709-4904
(907) 460-2166
Mailing address
PO BOX 74816, FAIRBANKS, AK 99707-4816
(907) 460-2166
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
376
AK
Other
Enumeration date
10/23/2006
Last updated
02/16/2009
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