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1003465873
RAPHILLA D DIXIE
FORT WAYNE, IN
NPI
1003465873
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: IN 87001756A)
Enumeration Date
2019-09-05
Last Update Date
2024-04-03
Business Address
RAPHILLA D DIXIE
3005 E STATE BLVD
FORT WAYNE, IN 46805-4736
Phone number: 260-267-9498
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Mailing Address
RAPHILLA D DIXIE
3005 E STATE BLVD
FORT WAYNE, IN 46805-4736
Phone number: 260-267-9498
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