Provider Demographics
NPI:1043682396
Name:DENNIS-GARY, BRIANNE NICOLE
Entity Type:Individual
Prefix:MISS
First Name:BRIANNE
Middle Name:NICOLE
Last Name:DENNIS-GARY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1421 N ARBOGAST ST
Mailing Address - Street 2:APT. 0B
Mailing Address - City:GRIFFITH
Mailing Address - State:IN
Mailing Address - Zip Code:46319-1868
Mailing Address - Country:US
Mailing Address - Phone:312-208-2260
Mailing Address - Fax:
Practice Address - Street 1:1421 N ARBOGAST ST
Practice Address - Street 2:APT. 0B
Practice Address - City:GRIFFITH
Practice Address - State:IN
Practice Address - Zip Code:46319-1868
Practice Address - Country:US
Practice Address - Phone:312-208-2260
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-27
Last Update Date:2015-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health