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General NPI Number Information
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NPI Number | 1720718026
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Entity Type | Individual
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Provider Name | ARIANA NICOLE DIXON # MHCA.MC.61321123
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Gender | Female
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Dates
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Enumeration Date | 06/10/2022
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Last Update Date | 06/10/2022
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Provider Practice Location Address
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Address Line | 11511 205TH AVE E
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City | BONNEY LAKE
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State | WA
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Zip | 98391-7722
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Country | US
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Telephone | 253-754-8021
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Fax |
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Provider Business Mailing Address
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Address Line | 522 W RIVERSIDE AVE STE 8122
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City | SPOKANE
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State | WA
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Zip | 99201-0580
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Country | US
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Telephone | 253-754-8021
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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 | MHCA.MC.61321123
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License Number State | WA
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