Provider Demographics
NPI:1396259982
Name:DIXON, CHRISTINA DANIELLE
Entity type:Individual
Prefix:MISS
First Name:CHRISTINA
Middle Name:DANIELLE
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 1:218 STARCREST DR
Mailing Address - Street 2:
Mailing Address - City:PIKEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27863-9550
Mailing Address - Country:US
Mailing Address - Phone:910-990-4655
Mailing Address - Fax:
Practice Address - Street 1:218 STARCREST DR
Practice Address - Street 2:
Practice Address - City:PIKEVILLE
Practice Address - State:NC
Practice Address - Zip Code:27863-9550
Practice Address - Country:US
Practice Address - Phone:910-990-4655
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-20
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA13060101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional