Provider Demographics
NPI:1437274636
Name:DIXON-WOOD, VIRGINIA (MA)
Entity type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:
Last Name:DIXON-WOOD
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10503 NW 25TH PL
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32606-5137
Mailing Address - Country:US
Mailing Address - Phone:352-331-7083
Mailing Address - Fax:352-334-0245
Practice Address - Street 1:435 DAUER HALL, BUCKMAN DRIVE
Practice Address - Street 2:UNIVERSITY OF FLORIDA SPEECH AND HEARING CLINIC
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32611-7420
Practice Address - Country:US
Practice Address - Phone:352-392-2041
Practice Address - Fax:352-846-0243
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0529235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL8833273-0Medicaid