Individual
MS. JACQUELYN E DICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA PSYCH
Contact information
Practice address
790 E JOHNS PRAIRIE RD., SHELTON, WA 98584
(360) 432-3521
Mailing address
790 E JOHNS PRAIRIE RD, SHELTON, WA 98584-1265
(360) 432-3521
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LH00009899
WA
Other
Enumeration date
05/08/2007
Last updated
04/14/2017
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