Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 1617 | AZ |
NPI | 1073681979 |
---|---|
Provider Name | Dr. Harold Carlton Dickens |
First Address | Fort Belvoir, VA 22060-0485 |
Second Address | Fort Belvoir, VA 22060-5805 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/12/2006 |
Last Update Date | 08/07/2007 |