Provider Demographics
NPI:1083656649
Name:DIXON, AMANDA TAYLOR (MS, OT, CHT)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:TAYLOR
Last Name:DIXON
Suffix:
Gender:F
Credentials:MS, OT, CHT
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:BROOKE
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, OT
Mailing Address - Street 1:317 S MCKENZIE ST
Mailing Address - Street 2:
Mailing Address - City:FOLEY
Mailing Address - State:AL
Mailing Address - Zip Code:36535-1926
Mailing Address - Country:US
Mailing Address - Phone:251-943-0441
Mailing Address - Fax:251-930-6334
Practice Address - Street 1:317 S MCKENZIE ST
Practice Address - Street 2:
Practice Address - City:FOLEY
Practice Address - State:AL
Practice Address - Zip Code:36535-1926
Practice Address - Country:US
Practice Address - Phone:251-943-0441
Practice Address - Fax:251-930-6334
Is Sole Proprietor?:No
Enumeration Date:2006-06-11
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2182225X00000X, 225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist