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1679034748
SCOTT MICHAEL DICKINSON
SHELTON, WA
NPI
1679034748
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WA CP00004514)
Enumeration Date
2019-03-29
Last Update Date
2022-02-24
Business Address
SCOTT MICHAEL DICKINSON SUDP
506 W FRANKLIN ST
SHELTON, WA 98584-3517
Phone number: 360-427-5232
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Mailing Address
SCOTT MICHAEL DICKINSON SUDP
PO BOX 59
CHEHALIS, WA 98532-0059
Phone number: 360-463-0927
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