Individual
MARIE ANTOINETTE DIXON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
737 DUNN RD, HAZELWOOD, MO 63042-1740
(314) 736-0873
Mailing address
1535 ESTES DR, FLORISSANT, MO 63031-4236
(314) 736-0873
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
2012034582
MO
1041C0700X
Clinical Social Worker
Primary
2017037198
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
490063669
—
MO
Enumeration date
04/19/2013
Last updated
10/26/2022
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