Basic Information
| Provider Information | |||||||||
| NPI: | 1013119726 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ALLEN | ||||||||
| FirstName: | DIXIE | ||||||||
| MiddleName: | |||||||||
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| Credential: | LPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1406 N 2475 W | ||||||||
| Address2: | |||||||||
| City: | LAYTON | ||||||||
| State: | UT | ||||||||
| PostalCode: | 840417763 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8014440974 | ||||||||
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| Practice Location | |||||||||
| Address1: | 698 12TH ST | ||||||||
| Address2: | |||||||||
| City: | OGDEN | ||||||||
| State: | UT | ||||||||
| PostalCode: | 844045877 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8016213466 | ||||||||
| FaxNumber: | 8016218811 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/04/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | 5118571-6004 | UT | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.