Healthcare Provider Details

I. General information

NPI: 1548199656
Provider Name (Legal Business Name): JILLIAN LEIGH DODSON AUD, CCC-A
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2026
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30055 NORTHWESTERN HWY STE 101
FARMINGTON HILLS MI
48334-3260
US

IV. Provider business mailing address

42320 FOUNTAIN PARK DR S APT 260
NOVI MI
48375-2551
US

V. Phone/Fax

Practice location:
  • Phone: 248-865-4166
  • Fax:
Mailing address:
  • Phone: 304-670-5591
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: