Provider Demographics
NPI:1962564047
Name:DICKEN, RICHARD J (MA)
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:J
Last Name:DICKEN
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Gender:M
Credentials:MA
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Mailing Address - Street 1:RICHARD ROUDEBUSH VA MEDICAL CENRTER
Mailing Address - Street 2:1481 WEST 10TH STREET
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46202
Mailing Address - Country:US
Mailing Address - Phone:317-554-0000
Mailing Address - Fax:317-226-0455
Practice Address - Street 1:RICHARD ROUDEBUSH VA MEDICAL CENRTER
Practice Address - Street 2:1481 WEST 10TH STREET
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202
Practice Address - Country:US
Practice Address - Phone:317-554-0000
Practice Address - Fax:317-226-0455
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2007-07-08
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor