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Individual

MRS. KENYA L MOORE DIXON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ALC

Contact information

Practice address
4819 SUNSHINE DR, MONTGOMERY, AL 36116-2882
(334) 440-4028
Mailing address
4819 SUNSHINE DR, MONTGOMERY, AL 36116-2882
(334) 440-4028

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
C3415A
AL
101YM0800X
Mental Health Counselor
Primary
C3415A
AL
101YP2500X
Professional Counselor
C3415A
AL

Other

Enumeration date
12/03/2019
Last updated
12/04/2019
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