Provider Demographics
NPI:1801861869
Name:HEUTON, DIXIE ANN (PHD)
Entity Type:Individual
Prefix:DR
First Name:DIXIE
Middle Name:ANN
Last Name:HEUTON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:318 NE BEL AIRE RD
Mailing Address - Street 2:
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50021-1918
Mailing Address - Country:US
Mailing Address - Phone:515-964-5833
Mailing Address - Fax:515-964-5833
Practice Address - Street 1:3600 30TH ST
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50310-5753
Practice Address - Country:US
Practice Address - Phone:515-699-5999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-22
Last Update Date:2013-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE543103TC0700X
IA001279103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE08125OtherBLUE CROSSBLUE SHIELD
NE35255OtherMIDLANDS CHOICE
NE10025167900Medicaid
NE278608Medicare UPIN