Healthcare Provider Details

I. General information

NPI: 1134384373
Provider Name (Legal Business Name): DOROTHY ROSE DENNY HASKELL MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DOROTHY ROSE DENNY MSW, LCSW

II. Dates (important events)

Enumeration Date: 07/28/2008
Last Update Date: 08/31/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 UNIVERSITY BLVD KATHY J. WEINMAN BUILDING
SAINT LOUIS MO
63121-4400
US

IV. Provider business mailing address

1 UNIVERSITY BLVD KATHY J. WEINMAN BUILDING
SAINT LOUIS MO
63121-4400
US

V. Phone/Fax

Practice location:
  • Phone: 314-516-7341
  • Fax: 314-516-6624
Mailing address:
  • Phone: 314-516-7337
  • Fax: 314-516-6624

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2008021556
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: