Provider Demographics
NPI:1447004668
Name:DIXON, VICTORIA ROSE (OTR/L)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:ROSE
Last Name:DIXON
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 SAXON WOODS PK DR
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10605-4816
Mailing Address - Country:US
Mailing Address - Phone:845-264-8819
Mailing Address - Fax:
Practice Address - Street 1:23 MILLER HILL RD
Practice Address - Street 2:
Practice Address - City:HOPEWELL JCT
Practice Address - State:NY
Practice Address - Zip Code:12533-6823
Practice Address - Country:US
Practice Address - Phone:845-264-8819
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-15
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist