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Individual

MARTY DIXON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
2731 KLAMATH LN, NAMPA, ID 83686-7940
(208) 353-3695
Mailing address
2731 KLAMATH LN, NAMPA, ID 83686-7940

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC-10128
ID

Other

Enumeration date
01/11/2024
Last updated
01/11/2024
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