Healthcare Provider Details

I. General information

NPI: 1164133054
Provider Name (Legal Business Name): MARY ANNA DILL M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/12/2022
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 LOCUST ST STE 2
GADSDEN AL
35901-3736
US

IV. Provider business mailing address

350 LOCUST ST STE 2
GADSDEN AL
35901-3736
US

V. Phone/Fax

Practice location:
  • Phone: 256-393-4435
  • Fax: 256-646-1270
Mailing address:
  • Phone: 256-393-4435
  • Fax: 256-646-1270

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: