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General NPI Number Information
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NPI Number | 1376776393
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Entity Type | Individual
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Provider Name | ERIC DAVID DENNISON ED.D
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Gender | Male
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Dates
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Enumeration Date | 08/25/2009
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Last Update Date | 08/25/2009
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Provider Practice Location Address
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Address Line | 717 12TH ST SUITE 118
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City | BEAVER FALLS
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State | PA
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Zip | 15010-4479
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Country | US
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Telephone | 724-843-4647
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Fax | 724-843-8033
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Provider Business Mailing Address
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Address Line | 717 12TH ST SUITE 118
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City | BEAVER FALLS
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State | PA
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Zip | 15010-4479
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Country | US
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Telephone | 724-843-4647
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Fax | 724-843-8033
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP1600X
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Taxonomy Name | Pastoral Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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