Healthcare Provider Details

I. General information

NPI: 1811469802
Provider Name (Legal Business Name): NICOLE DIXON MA CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: NICOLE SCHONAUER MA CCC-SLP

II. Dates (important events)

Enumeration Date: 01/02/2019
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

302 BUCHTEL MALL
AKRON OH
44325-3001
US

IV. Provider business mailing address

302 BUCHTEL MALL POLSKY 181
AKRON OH
44325-3001
US

V. Phone/Fax

Practice location:
  • Phone: 330-972-4349
  • Fax: 330-972-7884
Mailing address:
  • Phone: 330-972-4349
  • Fax: 330-972-7884

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSP.14240
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: