MEDICARE: CLEO DILLON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	6793	AL

General Provider Information

NPI Number	:	1174495543
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CLEO DILLON

Provider Business Mailing Address
First Line	:	1253 CINDY CIR
Second Line	:
City	:	KENT
State	:	OH
Zip	:	44240-5019
Country	:	US
Telephone Number	:	646-592-1120
Fax Number	:

Provider Business Practice Location Address
First Line	:	678 2ND ST W
Second Line	:
City	:	SONOMA
State	:	CA
Zip	:	95476-6901
Country	:	US
Telephone Number	:	707-938-1096
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/23/2025
Last Update Date	:	09/23/2025

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Directions to “ CLEO DILLON ” Practice Location

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