Provider Demographics
NPI:1023854627
Name:DIXON, LYRIK HAYLIE
Entity type:Individual
Prefix:
First Name:LYRIK
Middle Name:HAYLIE
Last Name:DIXON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6211 NW 14TH PL
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33313-6135
Mailing Address - Country:US
Mailing Address - Phone:954-412-1502
Mailing Address - Fax:
Practice Address - Street 1:325 JOHN KNOX RD
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32303-4113
Practice Address - Country:US
Practice Address - Phone:850-921-0772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-02
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker