| NPI | 1134425929 |
|---|---|
| Former Name | TRACY JO DIXON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: AZ PSY-004145) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: OR 3289) |
| Enumeration Date | 2011-01-27 |
| Last Update Date | 2025-05-02 |