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General NPI Number Information
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NPI Number | 1548963929
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Entity Type | Individual
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Provider Name | DAVID ROGER DIXON MS, NCC, RMHCI
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Gender | Male
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Dates
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Enumeration Date | 03/23/2023
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Last Update Date | 03/23/2023
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Provider Practice Location Address
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Address Line | 3937 TAMPA RD STE 3
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City | OLDSMAR
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State | FL
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Zip | 34677-3115
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Country | US
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Telephone | 813-501-6129
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Fax |
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Provider Business Mailing Address
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Address Line | 18608 ROCOCO RD
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City | SPRING HILL
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State | FL
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Zip | 34610-0090
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Country | US
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Telephone | 813-541-9159
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | IMH22242
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License Number State | FL
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