Provider Demographics
NPI:1487355004
Name:HINTON, DALE ANDREA
Entity type:Individual
Prefix:
First Name:DALE
Middle Name:ANDREA
Last Name:HINTON
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 1:7222 WATERS EDGE DR
Mailing Address - Street 2:
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30087-5324
Mailing Address - Country:US
Mailing Address - Phone:404-322-8864
Mailing Address - Fax:
Practice Address - Street 1:7222 WATERS EDGE DR
Practice Address - Street 2:
Practice Address - City:STONE MOUNTAIN
Practice Address - State:GA
Practice Address - Zip Code:30087-5324
Practice Address - Country:US
Practice Address - Phone:404-322-8864
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-10
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSW004738104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker