Provider Demographics
NPI:1447093901
Name:FRINK, DEANA SUZANNE (MED, CCC-SLP, PHD)
Entity type:Individual
Prefix:
First Name:DEANA
Middle Name:SUZANNE
Last Name:FRINK
Suffix:
Gender:F
Credentials:MED, CCC-SLP, PHD
Other - Prefix:
Other - First Name:DEANNA
Other - Middle Name:SUZANNE
Other - Last Name:SHUMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MED, CCC-SLP
Mailing Address - Street 1:110 CARLTON ST
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30602-5004
Mailing Address - Country:US
Mailing Address - Phone:706-542-4598
Mailing Address - Fax:706-249-4249
Practice Address - Street 1:110 CARLTON ST
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30602-5004
Practice Address - Country:US
Practice Address - Phone:706-542-4598
Practice Address - Fax:706-249-4249
Is Sole Proprietor?:No
Enumeration Date:2024-06-13
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA193200000X235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist