Provider Demographics
NPI:1124461900
Name:DIXON, MARIE ELIZABETH LOUGHLIN (OTL)
Entity type:Individual
Prefix:
First Name:MARIE
Middle Name:ELIZABETH LOUGHLIN
Last Name:DIXON
Suffix:
Gender:F
Credentials:OTL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6055 CEDAR WOOD DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-3674
Mailing Address - Country:US
Mailing Address - Phone:410-650-6885
Mailing Address - Fax:410-650-6886
Practice Address - Street 1:6055 CEDAR WOOD DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-3674
Practice Address - Country:US
Practice Address - Phone:410-650-6885
Practice Address - Fax:410-650-6886
Is Sole Proprietor?:No
Enumeration Date:2013-04-11
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD02414225XL0004X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XL0004XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistLow Vision