Doctor Name: | BETTY DIXON |
NPI Number: | 1184843609 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA, BHRS, CCMA |
License Number: | |
Business Practice Address: | Hc 79 Box 411 Hugo, OK - 747439320 |
Business Phone Number: | 5803267531 |
Business Fax Number: | 5803262377 |
Mailing Address: | Po Box 250, HUGO |
State: | OK |
Postal Code: | 747430250 |
Phone Number: | 5803267531 |
Fax Number: | 5803262377 |
NPI Enumeration Date: | 04/24/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |