MEDICARE: DR. DENA FRANCES LANDRY ED.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TS0200X	School Psychologist	SS724	FL
2	103K00000X	Behavior Analyst	11623490	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	SS724	OTHER	FL	LICENSE

General Provider Information

NPI Number	:	1174196315
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DENA FRANCES LANDRY ED.D.

Provider Business Mailing Address
First Line	:	206 BENNINGTON DR APT 1
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34104-1307
Country	:	US
Telephone Number	:	239-248-0285
Fax Number	:

Provider Business Practice Location Address
First Line	:	206 BENNINGTON DR APT 1
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34104-1307
Country	:	US
Telephone Number	:	239-248-0285
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/23/2021
Last Update Date	:	12/29/2025

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