| Doctor Name: | MR. BRUCE B DANNENBERGER |
| NPI Number: | 1033239728 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LCSW |
| License Number: | 149004294 |
| Business Practice Address: | 110 E Main St Suite 309 Ottawa, IL - 613502900 |
| Business Phone Number: | 8154342118 |
| Business Fax Number: | 8154345253 |
| Mailing Address: | 401 W Moore St, Suite 309 OTTAWA |
| State: | IL |
| Postal Code: | 613503855 |
| Phone Number: | 8154333662 |
| Fax Number: | |
| NPI Enumeration Date: | 03/29/2007 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 149004294 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |