Healthcare Provider Details

I. General information

NPI: 1295650182
Provider Name (Legal Business Name): YALANDA DIXON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3347 S ELECTRIC ST
DETROIT MI
48217-1134
US

IV. Provider business mailing address

3347 S ELECTRIC ST
DETROIT MI
48217-1134
US

V. Phone/Fax

Practice location:
  • Phone: 313-213-4732
  • Fax:
Mailing address:
  • Phone: 313-213-4732
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number900258439
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: