Provider Demographics
NPI:1497166532
Name:DIXON, TANIKA CECILIA (MSW)
Entity Type:Individual
Prefix:
First Name:TANIKA
Middle Name:CECILIA
Last Name:DIXON
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:182 GLENBROOK RD
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06610-1149
Mailing Address - Country:US
Mailing Address - Phone:203-870-5214
Mailing Address - Fax:
Practice Address - Street 1:74 EAST ST
Practice Address - Street 2:
Practice Address - City:PLAINVILLE
Practice Address - State:CT
Practice Address - Zip Code:06062-2367
Practice Address - Country:US
Practice Address - Phone:860-793-3500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-12
Last Update Date:2014-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical