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NPI Code Detail

MEDICARE: JILL MARIE DIXON MA, CCC-SLP

MEDICARE:   JILL MARIE DIXON  MA, CCC-SLP
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
1235Z00000XSpeech-Language PathologistSP 14179CA

General Provider Information

NPI Number : 1689838112
Entity Type Code : Individual
Provider Name (Legal Business Name) : JILL MARIE DIXON MA, CCC-SLP
Provider Business Mailing Address
First Line : 307 E FRONT ST
Second Line :
City : NEW BREMEN
State : OH
Zip : 45869-1215
Country : US
Telephone Number : 419-629-2545
Fax Number :
Provider Business Practice Location Address
First Line : 750 CHESTNUT ST
Second Line :
City : GREENVILLE
State : OH
Zip : 45331-1312
Country : US
Telephone Number : 937-547-8000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/14/2008
Last Update Date : 07/14/2008

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Directions to “ JILL MARIE DIXON MA, CCC-SLP” Practice Location

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