| Doctor Name: | TASHUA BERRY DENNIS |
| NPI Number: | 1063861003 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPC |
| License Number: | 3488 |
| Business Practice Address: | 2750 Pelham Rd S Unit 4 Anniston, AL - 362067567 |
| Business Phone Number: | 2562258769 |
| Business Fax Number: | 2564678086 |
| Mailing Address: | 308 Wilson Dr Sw, JACKSONVILLE |
| State: | AL |
| Postal Code: | 362652752 |
| Phone Number: | 2562258769 |
| Fax Number: | 2564678086 |
| NPI Enumeration Date: | 06/09/2016 |
| NPI Last Update Date: | 06/09/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 3488 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |