Doctor Name: | MS. RUTH GRETO DENNIS |
NPI Number: | 1417920588 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A. |
License Number: | PS006759L |
Business Practice Address: | 39 S Lake St North East, PA - 164281239 |
Business Phone Number: | 8147258545 |
Business Fax Number: | 8147258545 |
Mailing Address: | 39 S Lake St, NORTH EAST |
State: | PA |
Postal Code: | 164281239 |
Phone Number: | 8147258545 |
Fax Number: | 8147258545 |
NPI Enumeration Date: | 02/09/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | PS006759L |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |