Provider Demographics
NPI:1023178720
Name:DIX, DENISE D (MED, CCC,SLP)
Entity type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:D
Last Name:DIX
Suffix:
Gender:F
Credentials:MED, CCC,SLP
Other - Prefix:MISS
Other - First Name:DENISE
Other - Middle Name:D
Other - Last Name:SCHINDLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MED,CCC,SLP
Mailing Address - Street 1:154 WATER OAK DR
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31701-4778
Mailing Address - Country:US
Mailing Address - Phone:229-446-6098
Mailing Address - Fax:
Practice Address - Street 1:154 WATER OAK DR
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31701-4778
Practice Address - Country:US
Practice Address - Phone:229-446-6098
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP004621235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist