Provider Demographics
NPI:1679641096
Name:DIXON-BROWN, MARILYN MARIE (MS)
Entity Type:Individual
Prefix:
First Name:MARILYN
Middle Name:MARIE
Last Name:DIXON-BROWN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:MARIE
Other - Middle Name:
Other - Last Name:DIXON-BROWN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS
Mailing Address - Street 1:4601 DALE RD
Mailing Address - Street 2:HEAD AND NECK SURGERY AUDIOLOGY
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95356-9718
Mailing Address - Country:US
Mailing Address - Phone:209-735-7040
Mailing Address - Fax:
Practice Address - Street 1:4601 DALE RD
Practice Address - Street 2:HEAD AND NECK SURGERY AUDIOLOGY
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95356-9718
Practice Address - Country:US
Practice Address - Phone:209-735-7040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHA6054237600000X
CAAU1292231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter