Provider Demographics
NPI:1033461769
Name:DIXSON, CHARLOTTE D (MSED)
Entity Type:Individual
Prefix:
First Name:CHARLOTTE
Middle Name:D
Last Name:DIXSON
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:CHARLOTTE
Other - Middle Name:D
Other - Last Name:DIXSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:45 CARY AVE
Mailing Address - Street 2:
Mailing Address - City:OAKFIELD
Mailing Address - State:NY
Mailing Address - Zip Code:14125-1119
Mailing Address - Country:US
Mailing Address - Phone:585-738-7200
Mailing Address - Fax:
Practice Address - Street 1:45 CARY AVE
Practice Address - Street 2:
Practice Address - City:OAKFIELD
Practice Address - State:NY
Practice Address - Zip Code:14125-1119
Practice Address - Country:US
Practice Address - Phone:585-738-7200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-04
Last Update Date:2012-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist