Provider Demographics
NPI:1164019147
Name:DIXON, MALORI PAGE (CCHMC, NCC)
Entity type:Individual
Prefix:MS
First Name:MALORI
Middle Name:PAGE
Last Name:DIXON
Suffix:
Gender:F
Credentials:CCHMC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1121
Mailing Address - Street 2:
Mailing Address - City:ROSEBURG
Mailing Address - State:OR
Mailing Address - Zip Code:97470-0254
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1403 OREGON ST
Practice Address - Street 2:
Practice Address - City:PORT ORFORD
Practice Address - State:OR
Practice Address - Zip Code:97456
Practice Address - Country:US
Practice Address - Phone:801-746-9909
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-24
Last Update Date:2025-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health