Provider Demographics
NPI:1376325316
Name:DEW, DEONI
Entity Type:Individual
Prefix:
First Name:DEONI
Middle Name:
Last Name:DEW
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 1:21003 LEXINGTON FARMS DR
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30004-5303
Mailing Address - Country:US
Mailing Address - Phone:256-337-6741
Mailing Address - Fax:
Practice Address - Street 1:500 SUN VALLEY DR STE D2
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-5636
Practice Address - Country:US
Practice Address - Phone:770-910-9162
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-16
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor