Provider Demographics
NPI:1104069426
Name:DIXON, DIONNE ALLISON
Entity type:Individual
Prefix:MRS
First Name:DIONNE
Middle Name:ALLISON
Last Name:DIXON
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:DIONNE
Other - Middle Name:
Other - Last Name:DIXON-ALLEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3711 35TH AVE
Mailing Address - Street 2:SUITE 3C
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11101-1441
Mailing Address - Country:US
Mailing Address - Phone:718-706-7500
Mailing Address - Fax:718-706-9595
Practice Address - Street 1:3711 35TH AVE
Practice Address - Street 2:SUITE 3C
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11101-1441
Practice Address - Country:US
Practice Address - Phone:718-706-7500
Practice Address - Fax:718-706-9595
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-16
Last Update Date:2009-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013042225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist