Healthcare Provider Details

I. General information

NPI: 1578473153
Provider Name (Legal Business Name): ALICIA DAWSON M.A. CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

517 W KALAMAZOO ST
LANSING MI
48933-2008
US

IV. Provider business mailing address

1797 LOCHMOOR BLVD
JACKSON MI
49201-8308
US

V. Phone/Fax

Practice location:
  • Phone: 517-755-1000
  • Fax:
Mailing address:
  • Phone: 517-755-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number7101003374
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: