Organization
DICKENS INSPIRED LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NICOLE DICKENS M.D. (PRESIDENT)
(337) 412-6555
Entity
Organization
Contact information
Practice address
114 REPRESENTATIVE ROW, SUITE B, LAFAYETTE, LA 70508-3878
(337) 412-6555
Mailing address
114 REPRESENTATIVE ROW, SUITE B, LAFAYETTE, LA 70508-3878
(337) 412-6555
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
13406R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1564079
—
LA
Enumeration date
02/16/2015
Last updated
01/12/2016
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