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General NPI Number Information
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NPI Number | 1104598473
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Entity Type | Individual
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Provider Name | ALYSSA DIXON
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Gender | Female
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Dates
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Enumeration Date | 10/04/2021
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Last Update Date | 10/04/2021
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Provider Practice Location Address
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Address Line | 7041 TRANSIT RD
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City | EAST AMHERST
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State | NY
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Zip | 14051-1108
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Country | US
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Telephone | 888-805-0759
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Fax |
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Provider Business Mailing Address
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Address Line | 293 WASHINGTON ST
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City | LOCKPORT
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State | NY
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Zip | 14094-2129
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Country | US
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Telephone | 716-545-8489
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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