MEDICARE: JULIA LAUREN DIXSON OTR/L

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	OC019191	PA

General Provider Information

NPI Number	:	1982424347
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIA LAUREN DIXSON OTR/L

Provider Business Mailing Address
First Line	:	234 MAPLE RIDGE DR
Second Line	:
City	:	CANONSBURG
State	:	PA
Zip	:	15317-7300
Country	:	US
Telephone Number	:	724-541-3478
Fax Number	:

Provider Business Practice Location Address
First Line	:	249 W MCMURRAY RD
Second Line	:
City	:	MC MURRAY
State	:	PA
Zip	:	15317-2468
Country	:	US
Telephone Number	:	724-941-7150
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/11/2024
Last Update Date	:	10/11/2024

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