Doctor Name: | MR. MICHAEL PAUL DENNIS |
NPI Number: | 1669518304 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.S.L.P.C |
License Number: | 13086 |
Business Practice Address: | 602 N Main St Rockdale, TX - 765672323 |
Business Phone Number: | 2542890108 |
Business Fax Number: | 2547934271 |
Mailing Address: | Po Box 10612, KILLEEN |
State: | TX |
Postal Code: | 765470612 |
Phone Number: | 2542890108 |
Fax Number: | 2547934271 |
NPI Enumeration Date: | 01/29/2007 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 13086 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |