Provider Demographics
NPI:1386899334
Name:TRIPP-DINKINS, KATRINA L
Entity type:Individual
Prefix:MRS
First Name:KATRINA
Middle Name:L
Last Name:TRIPP-DINKINS
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:KATRINA
Other - Middle Name:L
Other - Last Name:TRIPP-DINKINS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:500 W LANIER AVE STE 904
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30214-7641
Mailing Address - Country:US
Mailing Address - Phone:678-817-1120
Mailing Address - Fax:770-719-9738
Practice Address - Street 1:500 W LANIER AVE STE 904
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30214-7641
Practice Address - Country:US
Practice Address - Phone:678-817-1120
Practice Address - Fax:770-719-9738
Is Sole Proprietor?:No
Enumeration Date:2008-11-18
Last Update Date:2008-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC005362101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health