Provider Demographics
NPI:1831718469
Name:DIXON, RACHEL MARY (OTRL)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:MARY
Last Name:DIXON
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 N LINN ST
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48706-4801
Mailing Address - Country:US
Mailing Address - Phone:989-402-8651
Mailing Address - Fax:
Practice Address - Street 1:4471 SHEFFIELD PL
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48706-2564
Practice Address - Country:US
Practice Address - Phone:989-684-6800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-14
Last Update Date:2020-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201009059225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist