Doctor Name: | DR. MARK A DENNISON |
NPI Number: | 1053562041 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LCPC, LPC |
License Number: | LPCC 0906 |
Business Practice Address: | 3146 N 450 E North Ogden, UT - 844141612 |
Business Phone Number: | 8013881650 |
Business Fax Number: | 8012164212 |
Mailing Address: | 3146 N 450 E, NORTH OGDEN |
State: | UT |
Postal Code: | 844141612 |
Phone Number: | 8013881650 |
Fax Number: | 8012164212 |
NPI Enumeration Date: | 10/08/2008 |
NPI Last Update Date: | 10/08/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | LPCC 0906 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | KY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |