Individual
EBONY DIXON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
914 E BROADWAY, LOUISVILLE, KY 40204-1037
(502) 589-8600
(502) 589-8745
Mailing address
101 W MUHAMMAD ALI BLVD, LOUISVILLE, KY 40202-1423
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
04/10/2013
Last updated
06/12/2014
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