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General NPI Number Information
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NPI Number | 1780899294
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Entity Type | Individual
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Provider Name | PAMELA LEE DENNISON LCSW
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Gender | Female
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Dates
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Enumeration Date | 05/10/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 13700 W. NATIONAL AVE
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City | NEW BERLIN
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State | WI
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Zip | 53151
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Country | US
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Telephone | 262-797-7979
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Fax | 262-796-9995
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Provider Business Mailing Address
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Address Line | 121 ARCADIAN AVE
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City | WAUKESHA
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State | WI
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Zip | 53186-5001
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Country | US
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Telephone | 414-803-4166
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Fax | 262-796-9995
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 7333
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License Number State | WI
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