Individual
CHARLES DICKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7240 CROWDER BLVD STE 202, NEW ORLEANS, LA 70127-1920
(504) 641-4577
(504) 641-4578
Mailing address
7240 CROWDER BLVD STE 202, NEW ORLEANS, LA 70127-1920
(504) 641-4577
(504) 641-4578
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
LA
Other
Enumeration date
11/29/2018
Last updated
01/15/2019
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