Healthcare Provider Details

I. General information

NPI: 1700391588
Provider Name (Legal Business Name): SARAH DIXON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/03/2017
Last Update Date: 06/14/2021
Certification Date: 06/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31557 SCHOOLCRAFT RD STE 200
LIVONIA MI
48150-1848
US

IV. Provider business mailing address

7400 WILDERNESS PARK DR APT 302
WESTLAND MI
48185-5992
US

V. Phone/Fax

Practice location:
  • Phone: 734-474-2958
  • Fax:
Mailing address:
  • Phone: 734-635-9909
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: