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General NPI Number Information
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NPI Number | 1356253892
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Entity Type | Individual
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Provider Name | LAURA DICKINSON
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Gender | Female
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Dates
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Enumeration Date | 09/21/2026
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Last Update Date | 09/21/2026
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Provider Practice Location Address
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Address Line | 7 MEDICAL LN STE H
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City | CONWAY
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State | AR
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Zip | 72034-4918
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Country | US
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Telephone | 501-255-3755
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Fax |
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Provider Business Mailing Address
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Address Line | 2655 COLLINS DR
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City | CONWAY
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State | AR
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Zip | 72034-9687
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Country | US
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Telephone | 816-223-9890
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Fax |
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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 | P2602006
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License Number State | AR
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