Organization
DECIA DIXON PHD LLC
Active
Other names
The Parent Child Practice
Organization subpart
No
Provider details
NPI number
Authorized official
DECIA N DIXON PHD (OWNER)
(678) 649-1940
Entity
Organization
Contact information
Practice address
2751 BUFORD HWY NE STE 410, ATLANTA, GA 30324-5457
(404) 507-6656
Mailing address
2751 BUFORD HWY NE STE 410, ATLANTA, GA 30324-5457
(678) 649-1940
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY003490
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003125580A
—
GA
Enumeration date
09/21/2017
Last updated
07/21/2022
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