Provider Demographics
NPI:1609350933
Name:DIXON, KAYLA MICHELLE (LSW, MSW)
Entity Type:Individual
Prefix:MRS
First Name:KAYLA
Middle Name:MICHELLE
Last Name:DIXON
Suffix:
Gender:F
Credentials:LSW, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47401 PUSKARICH RD
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIRSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43950-9458
Mailing Address - Country:US
Mailing Address - Phone:740-391-0519
Mailing Address - Fax:
Practice Address - Street 1:47401 PUSKARICH RD
Practice Address - Street 2:
Practice Address - City:SAINT CLAIRSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43950-9458
Practice Address - Country:US
Practice Address - Phone:740-391-0519
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-21
Last Update Date:2018-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.17011321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical