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General NPI Number Information
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NPI Number | 1609385673
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Entity Type | Organization
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Legal Business Name | DECIA DIXON PHD LLC
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Dates
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Enumeration Date | 09/21/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 2751 BUFORD HWY NE STE 410
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City | ATLANTA
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State | GA
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Zip | 30324-5457
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Country | US
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Telephone | 404-507-6656
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Fax |
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Provider Business Mailing Address
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Address Line | 2751 BUFORD HWY NE STE 410
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City | ATLANTA
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State | GA
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Zip | 30324-5457
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Country | US
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Telephone | 678-649-1940
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DECIA N DIXON
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Credential | PHD
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Telephone | 678-649-1940
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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 | PSY003490
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License Number State | GA
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