Provider Demographics
NPI:1588938658
Name:DINON, ANDREA
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:DINON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 W CHAPMAN RD
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-8895
Mailing Address - Country:US
Mailing Address - Phone:407-324-7772
Mailing Address - Fax:321-248-0717
Practice Address - Street 1:113 W CHAPMAN RD
Practice Address - Street 2:
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-8895
Practice Address - Country:US
Practice Address - Phone:407-324-7772
Practice Address - Fax:321-248-0717
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-06
Last Update Date:2013-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-13-14293103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1-13-14293OtherBCBA