Provider Demographics
NPI:1154875425
Name:DIXON, LIANE (MS, ATC, LAT)
Entity type:Individual
Prefix:
First Name:LIANE
Middle Name:
Last Name:DIXON
Suffix:
Gender:F
Credentials:MS, ATC, LAT
Other - Prefix:
Other - First Name:LIANE
Other - Middle Name:TESSA
Other - Last Name:ENGLISH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ATC, LAT
Mailing Address - Street 1:1 NANTUCKET DR
Mailing Address - Street 2:
Mailing Address - City:PALM COAST
Mailing Address - State:FL
Mailing Address - Zip Code:32137-2530
Mailing Address - Country:US
Mailing Address - Phone:813-505-9164
Mailing Address - Fax:
Practice Address - Street 1:1 NANTUCKET DR
Practice Address - Street 2:
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32137-2530
Practice Address - Country:US
Practice Address - Phone:813-505-9164
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-04
Last Update Date:2016-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL3111246Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other