Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor | ||
N | 103K00000X | Behavior Analyst |
NPI | 1003135252 |
---|---|
Provider Name | Ricky J Dingman |
First Address | Tacoma, WA 98407-3715 |
Second Address | Tacoma, WA 98407-3715 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/05/2010 |
Last Update Date | 27/05/2010 |