Individual
STACY DICKENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
203 N STATE ST, NORTH VERNON, IN 47265-2454
(812) 220-5157
Mailing address
203 N STATE ST, NORTH VERNON, IN 47265-2454
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
06/02/2021
Last updated
06/02/2021
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