Provider Demographics
NPI:1376848259
Name:KIME, DIXIE
Entity type:Individual
Prefix:DR
First Name:DIXIE
Middle Name:
Last Name:KIME
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 1:1705 WARREN AVE STE 304
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSPORT
Mailing Address - State:PA
Mailing Address - Zip Code:17701-2665
Mailing Address - Country:US
Mailing Address - Phone:570-824-3521
Mailing Address - Fax:570-326-1419
Practice Address - Street 1:1705 WARREN AVE STE 304
Practice Address - Street 2:
Practice Address - City:WILLIAMSPORT
Practice Address - State:PA
Practice Address - Zip Code:17701-2665
Practice Address - Country:US
Practice Address - Phone:570-824-3521
Practice Address - Fax:570-326-1419
Is Sole Proprietor?:No
Enumeration Date:2011-01-24
Last Update Date:2025-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS018097103G00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist