Provider Demographics
NPI:1184487480
Name:DIXON, AVANI
Entity type:Individual
Prefix:
First Name:AVANI
Middle Name:
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 1:14003 QUAIL SPRINGS PKWY
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73134-2602
Mailing Address - Country:US
Mailing Address - Phone:405-503-0863
Mailing Address - Fax:405-454-4010
Practice Address - Street 1:14003 QUAIL SPRINGS PKWY
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73134-2602
Practice Address - Country:US
Practice Address - Phone:405-503-0863
Practice Address - Fax:405-454-4010
Is Sole Proprietor?:No
Enumeration Date:2024-01-31
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst