MEDICARE: MISS DENETTA DIXON

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	103K00000X	Behavior Analyst	13345	LA
2	104100000X	Social Worker	13345	LA
3	171M00000X	Case Manager/Care Coordinator
4	1041C0700X	Clinical Social Worker	13345	LA

General Provider Information

NPI Number	:	1881057669
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS DENETTA DIXON

Provider Business Mailing Address
First Line	:	4955 W NAPOLEON AVE # 3012
Second Line	:
City	:	METAIRIE
State	:	LA
Zip	:	70001-2249
Country	:	US
Telephone Number	:	504-434-5137
Fax Number	:

Provider Business Practice Location Address
First Line	:	4955 W NAPOLEON AVE # 3012
Second Line	:
City	:	METAIRIE
State	:	LA
Zip	:	70001-2249
Country	:	US
Telephone Number	:	504-434-5137
Fax Number	:

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

Provider Enumeration Date	:	03/30/2016
Last Update Date	:	05/27/2025

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Directions to “ MISS DENETTA DIXON ” Practice Location

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