Provider Demographics
NPI:1023773983
Name:DIXON, DIANNA (IBCLC)
Entity type:Individual
Prefix:
First Name:DIANNA
Middle Name:
Last Name:DIXON
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10432 BALLS FORD RD STE 300
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20109-2517
Mailing Address - Country:US
Mailing Address - Phone:202-301-4725
Mailing Address - Fax:202-998-2038
Practice Address - Street 1:10432 BALLS FORD RD STE 300
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20109-2517
Practice Address - Country:US
Practice Address - Phone:202-301-4725
Practice Address - Fax:202-998-2038
Is Sole Proprietor?:No
Enumeration Date:2021-11-05
Last Update Date:2025-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAL-319037174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN