Provider Demographics
NPI:1073687638
Name:DIXON, DEBORA B (PHD)
Entity Type:Individual
Prefix:DR
First Name:DEBORA
Middle Name:B
Last Name:DIXON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 FRONT ST
Mailing Address - Street 2:
Mailing Address - City:BATH
Mailing Address - State:ME
Mailing Address - Zip Code:04530-2524
Mailing Address - Country:US
Mailing Address - Phone:207-443-3692
Mailing Address - Fax:207-443-3693
Practice Address - Street 1:48 FRONT ST
Practice Address - Street 2:
Practice Address - City:BATH
Practice Address - State:ME
Practice Address - Zip Code:04530-2524
Practice Address - Country:US
Practice Address - Phone:207-443-3692
Practice Address - Fax:207-443-3693
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2018-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME042270OtherANTHEM BCBS
ME042270OtherANTHEM BCBS