Provider Demographics
NPI:1285393454
Name:MULDROW-DIXON, TAQUANDA FRAMAE (LGMFT)
Entity type:Individual
Prefix:
First Name:TAQUANDA
Middle Name:FRAMAE
Last Name:MULDROW-DIXON
Suffix:
Gender:F
Credentials:LGMFT
Other - Prefix:
Other - First Name:TAQUANDA
Other - Middle Name:FRAMAE
Other - Last Name:DIXON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:8120 KNIGHTSBRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:MD
Mailing Address - Zip Code:20695-3417
Mailing Address - Country:US
Mailing Address - Phone:870-397-1340
Mailing Address - Fax:
Practice Address - Street 1:10665 STANHAVEN PL # 3118
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:MD
Practice Address - Zip Code:20695-3055
Practice Address - Country:US
Practice Address - Phone:240-222-3225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-14
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGM863106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist