Provider Demographics
NPI:1669534475
Name:DINNEEN, CARIE L (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:CARIE
Middle Name:L
Last Name:DINNEEN
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7224 BALDWIN RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:WARRENTON
Mailing Address - State:VA
Mailing Address - Zip Code:20187-4514
Mailing Address - Country:US
Mailing Address - Phone:540-349-3295
Mailing Address - Fax:
Practice Address - Street 1:7224 BALDWIN RIDGE RD
Practice Address - Street 2:
Practice Address - City:WARRENTON
Practice Address - State:VA
Practice Address - Zip Code:20187-4514
Practice Address - Country:US
Practice Address - Phone:540-349-3295
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202004278235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist