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NPI Code Detail

MEDICARE: SUSAN D DIXON M.A., C.C.C.

MEDICARE: SUSAN D DIXON M.A., C.C.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist22001801AIN

General Provider Information

NPI Number : 1073633962
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN D DIXON M.A., C.C.C.
Provider Business Mailing Address
First Line : 4541 E HACKER CREEK RD
Second Line :
City : MARTINSVILLE
State : IN
Zip : 46151-9357
Country : US
Telephone Number : 765-349-1353
Fax Number :
Provider Business Practice Location Address
First Line : 4541 E HACKER CREEK RD
Second Line :
City : MARTINSVILLE
State : IN
Zip : 46151-9357
Country : US
Telephone Number : 765-349-1353
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/02/2007
Last Update Date : 07/08/2007

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Directions to “ SUSAN D DIXON M.A., C.C.C.” Practice Location

Language Start Address Practice Location
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