Provider Demographics
NPI:1033463211
Name:DIXON, HEATHER LEEANN MILES
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:LEEANN MILES
Last Name:DIXON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14608 SYLENA WAY
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73170-7806
Mailing Address - Country:US
Mailing Address - Phone:405-306-6699
Mailing Address - Fax:
Practice Address - Street 1:1140 N HUDSON AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73103-3918
Practice Address - Country:US
Practice Address - Phone:405-272-0660
Practice Address - Fax:405-272-1596
Is Sole Proprietor?:No
Enumeration Date:2012-11-09
Last Update Date:2012-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor