MEDICARE: ANNA K DENDY PHD

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	103T00000X	Psychologist	P6983	OH

General Provider Information

NPI Number	:	1396086617
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNA K DENDY PHD

Provider Business Mailing Address
First Line	:	25101 CHAGRIN BLVD
Second Line	:	SUITE 100
City	:	BEACHWOOD
State	:	OH
Zip	:	44122-5643
Country	:	US
Telephone Number	:	216-831-6611
Fax Number	:	216-456-8128

Provider Business Practice Location Address
First Line	:	25101 CHAGRIN BLVD
Second Line	:	SUITE 100
City	:	BEACHWOOD
State	:	OH
Zip	:	44122-5643
Country	:	US
Telephone Number	:	216-831-6611
Fax Number	:	216-456-8128

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/12/2013
Last Update Date	:	09/06/2015

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