Provider Demographics
NPI:1598985947
Name:DIXON, MARNY R (LMHC)
Entity Type:Individual
Prefix:MS
First Name:MARNY
Middle Name:R
Last Name:DIXON
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1450 MADRUGA AVE
Mailing Address - Street 2:SUITE 310
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33146-3148
Mailing Address - Country:US
Mailing Address - Phone:305-663-5808
Mailing Address - Fax:305-663-5809
Practice Address - Street 1:1450 MADRUGA AVE
Practice Address - Street 2:SUITE 310
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146-3148
Practice Address - Country:US
Practice Address - Phone:305-663-5808
Practice Address - Fax:305-663-5809
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 3491101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health