Provider Demographics
NPI:1134584980
Name:DIXON, PRECIOUS FUFLAY (BSW, MA, ST)
Entity type:Individual
Prefix:MRS
First Name:PRECIOUS
Middle Name:FUFLAY
Last Name:DIXON
Suffix:
Gender:F
Credentials:BSW, MA, ST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 CROSSING BLVD
Mailing Address - Street 2:
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30253-8106
Mailing Address - Country:US
Mailing Address - Phone:770-875-8013
Mailing Address - Fax:
Practice Address - Street 1:3655 CANTON RD
Practice Address - Street 2:SUITE 201
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30066-2690
Practice Address - Country:US
Practice Address - Phone:678-903-5197
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-21
Last Update Date:2015-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional