Healthcare Provider Details

I. General information

NPI: 1033713508
Provider Name (Legal Business Name): ANNA DILLINER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/25/2020
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1292 WINDSOR DR
MINERAL WELLS WV
26150-6780
US

IV. Provider business mailing address

1292 WINDSOR DR
MINERAL WELLS WV
26150-6780
US

V. Phone/Fax

Practice location:
  • Phone: 304-580-6669
  • Fax:
Mailing address:
  • Phone: 304-580-6669
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: