Provider Demographics
NPI:1356725691
Name:DINNEEN, MARY FRANCES (LOM)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:FRANCES
Last Name:DINNEEN
Suffix:
Gender:F
Credentials:LOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5151 REED RD.,
Mailing Address - Street 2:SUITE 131-C
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43220
Mailing Address - Country:US
Mailing Address - Phone:614-975-6752
Mailing Address - Fax:614-888-9368
Practice Address - Street 1:5151 REED RD
Practice Address - Street 2:SUITE 131-C
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43220-2553
Practice Address - Country:US
Practice Address - Phone:614-975-6752
Practice Address - Fax:614-888-9368
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-16
Last Update Date:2015-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH000019171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist