Healthcare Provider Details

I. General information

NPI: 1316888548
Provider Name (Legal Business Name): MIKAILA DIXON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2026
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

413 W MONTGOMERY CROSS RD STE 600
SAVANNAH GA
31406-3364
US

IV. Provider business mailing address

18 MONICA BLVD
SAVANNAH GA
31419-1110
US

V. Phone/Fax

Practice location:
  • Phone: 615-560-6622
  • Fax:
Mailing address:
  • Phone: 912-445-1137
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: