Individual
MIA DICKENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
500 N MORAIN ST STE 1250, KENNEWICK, WA 99336-2967
(509) 492-1566
Mailing address
500 N MORAIN ST STE 1250, KENNEWICK, WA 99336-2967
(509) 492-1566
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
11/08/2019
Last updated
11/27/2019
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