Healthcare Provider Details

I. General information

NPI: 1093634792
Provider Name (Legal Business Name): DINA LYNETTE FARAMELLI
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1525 W FRYE RD
CHANDLER AZ
85224-6112
US

IV. Provider business mailing address

1565 W JUANITA CIR
MESA AZ
85202-5859
US

V. Phone/Fax

Practice location:
  • Phone: 480-812-7000
  • Fax:
Mailing address:
  • Phone: 480-466-3264
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: