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General NPI Number Information
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NPI Number | 1992922728
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Entity Type | Individual
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Provider Name | MELINDA DIXON
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Gender | Female
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Dates
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Enumeration Date | 04/20/2007
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Last Update Date | 03/10/2015
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Provider Practice Location Address
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Address Line | 1717 W 10TH ST
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City | AUSTIN
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State | TX
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Zip | 78703-3907
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Country | US
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Telephone | 512-804-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 4424 GAINES RANCH LOOP APT. 820
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City | AUSTIN
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State | TX
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Zip | 78735-6492
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Country | US
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Telephone |
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 202424
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License Number State | TX
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