Provider Information for 1932793965
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JULIETTE DIXON LCSW
Sex: Female
NPI: 1932793965
Last Updated: 2022-09-28
Certification Date: 2022-09-28
Certification Date: 2022-09-28
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1932793965 | ||||||||||||
| Enumeration Date | 2021-02-20 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | PO BOX 680353 MIAMI, FL 33168-0353 United States Phone: 305-985-9145 | Fax: | ||||||||||||
| Primary Practice Address | 5421 LYNX LN COLUMBIA, MD 21044-2495 United States Phone: 410-205-9638 | Fax: | ||||||||||||
| Secondary Practice Address(es) | 17710 NW 13TH CT | ||||||||||||
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