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MR. KIM RICHARD DISMUKES LPC

Professional >> Counselor >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1417064320

Individual Registrant:
MR. KIM RICHARD DISMUKES LPC
Gender: M
Sole Proprietor

Location and contact information for practice:
100 WESTSIDE DR  DOTHAM, AL 36303 US
Tel: 334-793-2237  Fax: 334-712-6256

Contact information for business:
100 WESTSIDE DR  DOTHAN, AL 36303-1908 US
Tel: 334-793-2237  Fax: 334-712-6256

Registration Information:
NPI: 1417064320
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y101YP2500XBehavioral Health & Social Service Providers
Counselor
Professional
AL459

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




HEALTH CARE JOBS AL - Page 1

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