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1679003743
THADDYEUS DIXON
SHREVEPORT, LA
NPI
1679003743
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2017-06-12
Last Update Date
2017-06-12
Business Address
-- THADDYEUS DIXON
2800 YOUREE DR STE 482
SHREVEPORT, LA 71104-3666
Phone number: 318-869-1899
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Mailing Address
-- THADDYEUS DIXON
1015 SEBILLE DR
ALEXANDRIA, LA 71303-5707
Phone number: 318-955-0078
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