Individual
KELLIE ANISSA DIX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1102 SMITH AVE, THOMASVILLE, GA 31792-5739
(229) 227-5449
(229) 227-2145
Mailing address
204 WILLIAMS ST, THOMASVILLE, GA 31792-6957
(229) 224-0269
(229) 227-2142
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC012322
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LPC012322
—
GA
Enumeration date
07/21/2021
Last updated
07/21/2021
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