Individual
TYRA DIXON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCASA
Contact information
Practice address
1927 J N PEASE PL, CHARLOTTE, NC 28262-4553
(704) 247-7742
(704) 548-9529
Mailing address
3530 DANIEL PLACE DR, CHARLOTTE, NC 28213-4817
(773) 716-8404
(704) 612-8213
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
3351-A
NC
101YM0800X
Mental Health Counselor
—
—
Other
Enumeration date
07/03/2013
Last updated
07/03/2013
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