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NPI Code Detail

MEDICARE: ANNE MARIE DENNIS MFT INTERN

MEDICARE: ANNE MARIE DENNIS MFT INTERN
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
1106H00000XMarriage & Family Therapist46124CA

General Provider Information

NPI Number : 1184753287
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANNE MARIE DENNIS MFT INTERN
Provider Business Mailing Address
First Line : 625 FAIR OAKS AVE
Second Line : SUITE 300
City : SOUTH PASADENA
State : CA
Zip : 91030-2630
Country : US
Telephone Number : 626-831-4367
Fax Number :
Provider Business Practice Location Address
First Line : 625 S. FAIR OAKS AVENUE
Second Line : SUITE 300
City : SOUTH PASADENA
State : CA
Zip : 91030-5805
Country : US
Telephone Number : 626-831-4367
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/05/2007
Last Update Date : 07/08/2007

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Directions to “ ANNE MARIE DENNIS MFT INTERN” Practice Location

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