Healthcare Provider Details

I. General information

NPI: 1942926217
Provider Name (Legal Business Name): SAKIA DIXON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2022
Last Update Date: 10/18/2022
Certification Date: 10/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7475 HALCYON POINTE DR
MONTGOMERY AL
36117-8053
US

IV. Provider business mailing address

247 HICKORY PL
WETUMPKA AL
36093-3731
US

V. Phone/Fax

Practice location:
  • Phone: 334-954-6010
  • Fax:
Mailing address:
  • Phone: 256-665-1621
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: