Individual
MS. AUDREY DIONNE DILLON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3679 FORD RD, MEMPHIS, TN 38109-3614
(901) 335-7251
Mailing address
3679 FORD RD, MEMPHIS, TN 38109-3614
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
1000000013286
TN
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
1000000013286
TN
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
1000000013286
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
H445768
—
TN
Enumeration date
10/31/2013
Last updated
10/31/2013
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