Provider Demographics
NPI:1801384508
Name:DIXON, JOSHUA (BS)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:
Last Name:DIXON
Suffix:
Gender:M
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11905 BOWMAN DR STE 507
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22408-7344
Mailing Address - Country:US
Mailing Address - Phone:540-395-9962
Mailing Address - Fax:
Practice Address - Street 1:11905 BOWMAN DR STE 507
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22408-7344
Practice Address - Country:US
Practice Address - Phone:540-395-9962
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-27
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst