Provider Demographics
NPI:1891469292
Name:DINGLE, LATONYA ADAMS
Entity Type:Individual
Prefix:MS
First Name:LATONYA
Middle Name:ADAMS
Last Name:DINGLE
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 1:400 W PEACHTREE ST NW STE 4-1401
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30308-3536
Mailing Address - Country:US
Mailing Address - Phone:888-684-2779
Mailing Address - Fax:
Practice Address - Street 1:871 CHANDLER RD
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30045-8164
Practice Address - Country:US
Practice Address - Phone:706-267-0956
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-09
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC012197101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional