Provider Demographics
NPI:1366047565
Name:DIXON, NATISHA (BCBA)
Entity type:Individual
Prefix:
First Name:NATISHA
Middle Name:
Last Name:DIXON
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:827 FAIRWAYS CT STE 100
Mailing Address - Street 2:
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-9068
Mailing Address - Country:US
Mailing Address - Phone:404-224-9346
Mailing Address - Fax:
Practice Address - Street 1:827 FAIRWAYS CT STE 100
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-9068
Practice Address - Country:US
Practice Address - Phone:404-224-9346
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-03
Last Update Date:2025-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1-25-83232103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst