Provider Demographics
NPI:1962098806
Name:DISON, ALANA M
Entity type:Individual
Prefix:
First Name:ALANA
Middle Name:M
Last Name:DISON
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 1:3070 BUSINESS PARK DR
Mailing Address - Street 2:
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30071-5404
Mailing Address - Country:US
Mailing Address - Phone:770-884-1050
Mailing Address - Fax:
Practice Address - Street 1:3070 BUSINESS PARK DR
Practice Address - Street 2:
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30071-5404
Practice Address - Country:US
Practice Address - Phone:770-884-1050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-15
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician