Individual
DIXIE LEE BLACKWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A. SLP
Contact information
Practice address
3900 BIRCH ST STE 103, NEWPORT BEACH, CA 92660-2226
(949) 955-0010
Mailing address
23222 LA VACA ST, LAKE FOREST, CA 92630-4523
(949) 244-7247
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
9702
CA
Other
Enumeration date
09/10/2015
Last updated
09/10/2015
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