Individual
TRACI DINNALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
440 WINN WAY, DECATUR, GA 30030-1715
(404) 294-0499
Mailing address
440 WINN WAY, DECATUR, GA 30030-1715
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
LPN080901
GA
Other
Enumeration date
04/29/2022
Last updated
04/29/2022
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