Healthcare Provider Details

I. General information

NPI: 1417422759
Provider Name (Legal Business Name): DINAMARCA CEDENO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/12/2018
Last Update Date: 09/29/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

406 HANOVER AV
ALLENTOWN PA
18109
US

IV. Provider business mailing address

406 HANOVER AVE
ALLENTOWN PA
18109-2150
US

V. Phone/Fax

Practice location:
  • Phone: 610-653-7493
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: