MEDICARE: DENNISON CONSULTING SERVICES INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	6801011209	MI

General Provider Information

NPI Number	:	1093877714
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DENNISON CONSULTING SERVICES INC

Provider Business Mailing Address
First Line	:	7590 MISTWOOD DR
Second Line	:
City	:	WHITE LAKE
State	:	MI
Zip	:	48383-3946
Country	:	US
Telephone Number	:	248-922-0680
Fax Number	:	248-922-2820

Provider Business Practice Location Address
First Line	:	7590 MISTWOOD DR
Second Line	:
City	:	WHITE LAKE
State	:	MI
Zip	:	48383-3946
Country	:	US
Telephone Number	:	248-922-0680
Fax Number	:	248-922-2820

Authorized Official
Title or Position	:	OWNER
Name	:	MARY KERR
Credential	:	MSW, ACSW
Telephone Number	:	248-922-0680

Provider Enumeration Date	:	12/16/2006
Last Update Date	:	10/29/2008

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