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NPI Code Detail

MEDICARE: MRS. KATRINA SUE DIXON LPC

MEDICARE: MRS. KATRINA SUE DIXON LPC
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
1101YM0800XMental Health CounselorE.1700287OH

General Provider Information

NPI Number : 1619339074
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KATRINA SUE DIXON LPC
Provider Business Mailing Address
First Line : 7570 BALES ST # 380
Second Line :
City : LIBERTY TOWNSHIP
State : OH
Zip : 45069-7516
Country : US
Telephone Number : 513-924-4953
Fax Number :
Provider Business Practice Location Address
First Line : 8904 BROOKSIDE AVE
Second Line :
City : WEST CHESTER
State : OH
Zip : 45069-3139
Country : US
Telephone Number : 513-644-1030
Fax Number : 513-644-1025
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/24/2016
Last Update Date : 01/08/2018

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