| Doctor Name: | MR. MARK ANDREW DIXON |
| NPI Number: | 1679624787 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LCSW |
| License Number: | 6635745-3501 |
| Business Practice Address: | 7321 11th St Bldg 547 Hill Afb, UT - 840565012 |
| Business Phone Number: | 8017773497 |
| Business Fax Number: | |
| Mailing Address: | 2566 W 1675 N, CLINTON |
| State: | UT |
| Postal Code: | 840155753 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 01/15/2007 |
| NPI Last Update Date: | 01/11/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 6635745-3501 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | UT |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |