Healthcare Provider Details

I. General information

NPI: 1023809019
Provider Name (Legal Business Name): HANNAH GILL DIXON AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2025
Last Update Date: 06/27/2025
Certification Date: 06/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2454 MONROE ST STE A
DEARBORN MI
48124-3038
US

IV. Provider business mailing address

2454 MONROE ST STE A
DEARBORN MI
48124-3038
US

V. Phone/Fax

Practice location:
  • Phone: 313-562-4100
  • Fax: 313-562-4590
Mailing address:
  • Phone: 313-562-4100
  • Fax: 313-562-4590

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number1601001204
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: