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General NPI Number Information
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NPI Number | 1336449693
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Entity Type | Individual
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Provider Name | CARRIE B. DIXON PH.D.
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Gender | Female
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Dates
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Enumeration Date | 11/02/2010
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Last Update Date | 11/02/2010
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Provider Practice Location Address
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Address Line | 100 W 11TH ST SUITE 100
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City | ANDERSON
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State | IN
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Zip | 46016-2069
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Country | US
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Telephone | 765-643-0181
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Fax | 765-643-0181
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Provider Business Mailing Address
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Address Line | 100 W 11TH ST 200
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City | ANDERSON
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State | IN
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Zip | 46016-2069
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Country | US
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Telephone | 317-643-0181
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Fax | 317-643-3442
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 20040075A
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License Number State | IN
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