Provider Information for 1114676368
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DIXIE EPPOLITO MS, LMHC
Sex: Female
NPI: 1114676368
Last Updated: 2022-12-07
Certification Date: 2022-12-07
Certification Date: 2022-12-07
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1114676368 | ||||||||
| Enumeration Date | 2022-03-23 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 1910 NAVARRE SCHOOL RD UNIT 5277 NAVARRE, FL 32566-6412 United States Phone: 850-684-5566 | Fax:850-546-4588 | ||||||||
| Primary Practice Address | 8536 HIGH SCHOOL BLVD NAVARRE, FL 32566-3218 United States Phone: 850-684-5566 | Fax:850-546-4588 | ||||||||
| Secondary Practice Address(es) | 114 CEDAR AVE STE 210 | ||||||||
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