Provider Demographics
NPI:1467566950
Name:DIXON, MARY JOANNE (PHD)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:JOANNE
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 1:4701 BAPTIST RD
Mailing Address - Street 2:SUITE 208A
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15227-1117
Mailing Address - Country:US
Mailing Address - Phone:412-882-9929
Mailing Address - Fax:412-882-9949
Practice Address - Street 1:4701 BAPTIST RD
Practice Address - Street 2:SUITE 208A
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15227-1117
Practice Address - Country:US
Practice Address - Phone:412-882-9929
Practice Address - Fax:412-882-9949
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS004663L103TB0200X, 103TC0700X, 103TC2200X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist