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General NPI Number Information
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NPI Number | 1962665109
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Entity Type | Individual
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Provider Name | ALECIA LYNN DIXON M.S.
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Gender | Female
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Dates
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Enumeration Date | 07/08/2008
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Last Update Date | 09/13/2024
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Provider Practice Location Address
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Address Line | 9000 NE WEST KINGSTON RD
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City | KINGSTON
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State | WA
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Zip | 98346-9327
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Country | US
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Telephone | 314-920-1523
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Fax |
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Provider Business Mailing Address
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Address Line | 22275 DAUNTLESS DR NW UNIT 108
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City | POULSBO
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State | WA
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Zip | 98370-4009
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Country | US
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Telephone | 314-920-1523
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | TSLP-1747
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 2009036119
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | LL60299421
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License Number State | WA
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