Individual
MS. LISA R DICKENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS, CAC-AD
Contact information
Practice address
975 SOLOMONS ISLAND RD N, PRINCE FREDERICK, MD 20678-3917
(410) 535-5400
(410) 535-5285
Mailing address
P.O. BOX 980, PRINCE FREDERICK, MD 20678
(410) 535-5400
(410) 535-5285
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
08/19/2008
Last updated
07/16/2013
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