Provider Demographics
NPI:1790475002
Name:DIXON, LAURA JANINE (AUD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:JANINE
Last Name:DIXON
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18323 E MAINSTREET APT 4102
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-4786
Mailing Address - Country:US
Mailing Address - Phone:908-239-3181
Mailing Address - Fax:
Practice Address - Street 1:11211 DRANSFELDT RD STE 133
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-9388
Practice Address - Country:US
Practice Address - Phone:908-239-3181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-10
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAUD.0001183231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist