NPI 1003465873

Raphilla D Dixie

Practitioner Addiction (Substance Use Disorder) Counselor Fort Wayne, IN

Practice location

Address: 3005 E State Blvd, Fort Wayne, IN 46805-4736
Phone: (260) 267-9498
Fax: (260) 739-3618

Registered specialties

Addiction (Substance Use Disorder) Counselor Primary

Behavioral Health & Social Service Providers Taxonomy 101YA0400X Licence 87001756A (IN)

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Registry record

NPI: 1003465873
Entity type: Individual
Sex (as registered): Female
NPI issued: 5 Sep 2019
Record last updated: 3 Apr 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.