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Organization

PATRICIA S DIXON-PSYD

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. PATRICIA SHALENE DIXON PSY.D. (CLINICAL PSYCHOLOGIST)
(727) 322-6123
Entity
Organization

Contact information

Practice address
5348 1ST AVE N, ST PETERSBURG, FL 33710-8106
(727) 322-6123
Mailing address
PO BOX 47918, ST PETERSBURG, FL 33743-7918
(727) 322-6143

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
PY8356
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1598046286
NPI
Enumeration date
09/21/2011
Last updated
09/21/2011
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