Individual
KRISTIN DIXON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
1800 COLONIAL DR, COLUMBIA, SC 29203-6827
(803) 898-2636
Mailing address
1800 COLONIAL DR, COLUMBIA, SC 29203-6827
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
10414
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1770667867
—
SC
Enumeration date
05/28/2014
Last updated
05/28/2014
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