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General NPI Number Information
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NPI Number | 1154329639
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Entity Type | Individual
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Provider Name | GINGER RHEA DICKSON L.P.C.
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Gender | Female
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Dates
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Enumeration Date | 07/08/2005
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Last Update Date | 07/24/2007
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Provider Practice Location Address
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Address Line | 6245 LOCKE AVE
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City | FORT WORTH
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State | TX
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Zip | 76116-4636
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Country | US
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Telephone | 817-291-0141
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Fax | 817-732-5022
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Provider Business Mailing Address
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Address Line | 6245 LOCKE AVE
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City | FORT WORTH
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State | TX
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Zip | 76116-4636
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Country | US
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Telephone | 817-291-0141
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Fax | 817-732-5022
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 15579
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License Number State | TX
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