Provider Demographics
NPI:1083378335
Name:DIXON, JOANNA (COTA)
Entity Type:Individual
Prefix:
First Name:JOANNA
Middle Name:
Last Name:DIXON
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3925 MIDLANDS RD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23188-2575
Mailing Address - Country:US
Mailing Address - Phone:757-585-3216
Mailing Address - Fax:
Practice Address - Street 1:3925 MIDLANDS RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23188-2575
Practice Address - Country:US
Practice Address - Phone:757-585-3216
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-23
Last Update Date:2021-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant