Individual
SAMANTHA DICKENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CSFA
Contact information
Practice address
70458 SILAS THOMAS RD, PEARL RIVER, LA 70452-2460
(985) 707-3017
Mailing address
70458 SILAS THOMAS RD, PEARL RIVER, LA 70452-2460
(985) 707-3017
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
114115
LA
Other
Enumeration date
10/20/2009
Last updated
12/25/2011
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