Healthcare Provider Details

I. General information

NPI: 1982913323
Provider Name (Legal Business Name): ANN K. DENNISON M.ED., LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2010
Last Update Date: 03/28/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2285 BENDEN DR
WOOSTER OH
44691-2568
US

IV. Provider business mailing address

125 BALDWIN ST
WADSWORTH OH
44281-1837
US

V. Phone/Fax

Practice location:
  • Phone: 330-264-9029
  • Fax: 330-263-7251
Mailing address:
  • Phone: 330-334-2574
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberE0002069
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: