MEDICARE: SARAH BOWEN DIX LCSW

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
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1477744084
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH BOWEN DIX LCSW

Provider Business Mailing Address
First Line	:	1810 N EDISON ST
Second Line	:
City	:	ARLINGTON
State	:	VA
Zip	:	22207-1938
Country	:	US
Telephone Number	:	703-228-0573
Fax Number	:

Provider Business Practice Location Address
First Line	:	1810 N EDISON ST
Second Line	:
City	:	ARLINGTON
State	:	VA
Zip	:	22207-1938
Country	:	US
Telephone Number	:	703-228-0573
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/08/2007
Last Update Date	:	01/11/2011

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