Provider Demographics
NPI:1518411883
Name:DIXON, MAREN KAY (PT, DPT)
Entity Type:Individual
Prefix:
First Name:MAREN
Middle Name:KAY
Last Name:DIXON
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7080 DEEPAGE DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-5219
Mailing Address - Country:US
Mailing Address - Phone:410-381-7000
Mailing Address - Fax:
Practice Address - Street 1:7080 DEEPAGE DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-5219
Practice Address - Country:US
Practice Address - Phone:410-381-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-04
Last Update Date:2016-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD26073225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist