Provider Demographics
NPI:1003050816
Name:DINARTE, ANDREA LEIGH
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:LEIGH
Last Name:DINARTE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:156 PINE KNOLL DR
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:GA
Mailing Address - Zip Code:30117-2451
Mailing Address - Country:US
Mailing Address - Phone:770-832-8243
Mailing Address - Fax:
Practice Address - Street 1:156 PINE KNOLL DR
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:GA
Practice Address - Zip Code:30117-2451
Practice Address - Country:US
Practice Address - Phone:770-832-8243
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-23
Last Update Date:2020-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2902235Z00000X
GASLP007499235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist