Individual
DINAH LYNN SPENCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
318 W PIKE ST, SUITE 104, LAWRENCEVILLE, GA 30045-3234
(678) 377-2833
Mailing address
5322 DEEP SPRINGS DR, STONE MOUNTAIN, GA 30087-3628
(404) 634-5291
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT002640
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00819277B
—
GA
01
—
10037598
AMERIGROUP-AAKTS
GA
01
—
307935
WELLCARE- AAKTS
GA
Enumeration date
12/05/2006
Last updated
07/09/2007
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