Mackenzie Taylor Dixon, RBT
Individual provider Active NPI Behavior Technician · Jesup, GA
NPI 1639760648 · NPPES record last updated Feb 2, 2021
Key facts
- NPI
- 1639760648
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- License
- RBT-21-154016
- Practice address
- 1316 W Orange St
Jesup, GA 31545-0714 - Phone
- (912) 385-2927
- Fax
- (912) 385-2928
- NPI assigned
- Feb 2, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Howard Center for Social Cognition and Communication | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | RBT-21-154016 | Yes |
Addresses
Primary practice location
1316 W Orange St
Jesup, GA 31545-0714
Mailing address
1316 W Orange St
Jesup, GA 31545-0714
Phone (912) 385-2927
Other practice location 1
413 Lister St
Waycross, GA 31501-5225
Phone (912) 385-2927
Other providers in Jesup, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 2, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.