| Doctor Name: | LARRY E DIXON |
| NPI Number: | 1124266903 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | L.S.A.C. |
| License Number: | 331882-6006 |
| Business Practice Address: | 58 E Main St Ste 7 Delta, UT - 846249500 |
| Business Phone Number: | 4359796372 |
| Business Fax Number: | 4358641669 |
| Mailing Address: | Po Box 387, DELTA |
| State: | UT |
| Postal Code: | 846240387 |
| Phone Number: | 4359796372 |
| Fax Number: | 4358641669 |
| NPI Enumeration Date: | 02/01/2009 |
| NPI Last Update Date: | 02/01/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 331882-6006 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | UT |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |