Provider Demographics
NPI:1033161906
Name:DIXON, JEAN F (LMHC)
Entity Type:Individual
Prefix:
First Name:JEAN
Middle Name:F
Last Name:DIXON
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7413 ALAFIA RIDGE LOOP
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33569-4773
Mailing Address - Country:US
Mailing Address - Phone:813-672-2114
Mailing Address - Fax:352-518-0063
Practice Address - Street 1:7413 ALAFIA RIDGE LOOP
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33569-4773
Practice Address - Country:US
Practice Address - Phone:813-672-2114
Practice Address - Fax:352-518-0063
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH2356101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor