| Doctor Name: | CORY BRAD DENNIS |
| NPI Number: | 1922324573 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | 5947893-3501 |
| Business Practice Address: | 411 Loudon Rd Loudonville, NY - 122111722 |
| Business Phone Number: | 5189561901 |
| Business Fax Number: | |
| Mailing Address: | 20 S Dove St Apt 1, ALBANY |
| State: | NY |
| Postal Code: | 122021206 |
| Phone Number: | 5189561901 |
| Fax Number: | |
| NPI Enumeration Date: | 04/07/2010 |
| NPI Last Update Date: | 04/07/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 5947893-3501 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | UT |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |