Provider Demographics
NPI:1821725029
Name:DIXON, DANIELLE (CD)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:DIXON
Suffix:
Gender:F
Credentials:CD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 HOLBROOK PL
Mailing Address - Street 2:
Mailing Address - City:ANSONIA
Mailing Address - State:CT
Mailing Address - Zip Code:06401-1207
Mailing Address - Country:US
Mailing Address - Phone:475-309-8084
Mailing Address - Fax:
Practice Address - Street 1:27 HOLBROOK PL
Practice Address - Street 2:
Practice Address - City:ANSONIA
Practice Address - State:CT
Practice Address - Zip Code:06401-1207
Practice Address - Country:US
Practice Address - Phone:475-309-8084
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-07
Last Update Date:2022-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula