Individual
CHARLES RICHARD DIXON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LSW
Contact information
Practice address
308 E BROAD ST, BETHLEHEM, PA 18018-6311
(610) 861-8779
Mailing address
308 E BROAD ST, BETHLEHEM, PA 18018-6311
(610) 861-8779
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CADC7182
PA
104100000X
Social Worker
Primary
SW133031
PA
Other
Enumeration date
02/03/2016
Last updated
02/03/2016
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