Healthcare Provider Details

I. General information

NPI: 1144808668
Provider Name (Legal Business Name): DINEKE CHANTELLE TURNER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/29/2021
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12395 MORRIS RD
ALPHARETTA GA
30005-4000
US

IV. Provider business mailing address

6505 SHILOH RD STE 100
ALPHARETTA GA
30005-1645
US

V. Phone/Fax

Practice location:
  • Phone: 678-648-7644
  • Fax:
Mailing address:
  • Phone: 678-648-7644
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-2826397
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: