Healthcare Provider Details

I. General information

NPI: 1316620339
Provider Name (Legal Business Name): DENNIS BRADLEY PLOOF MS, ALC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2023
Last Update Date: 10/26/2023
Certification Date: 10/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

319 AL HIGHWAY 75 N STE B
ALBERTVILLE AL
35951-3837
US

IV. Provider business mailing address

319 AL HIGHWAY 75 N STE B
ALBERTVILLE AL
35951-3837
US

V. Phone/Fax

Practice location:
  • Phone: 256-513-9220
  • Fax:
Mailing address:
  • Phone: 256-660-0796
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberALC04533
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: