Provider Demographics
NPI:1164529517
Name:DENNLER, JEANNE (PHD)
Entity Type:Individual
Prefix:DR
First Name:JEANNE
Middle Name:
Last Name:DENNLER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2340 DETROIT AVE
Mailing Address - Street 2:C-1
Mailing Address - City:MAUMEE
Mailing Address - State:OH
Mailing Address - Zip Code:43537-3766
Mailing Address - Country:US
Mailing Address - Phone:419-893-2728
Mailing Address - Fax:419-893-0475
Practice Address - Street 1:2340 DETROIT AVENUE
Practice Address - Street 2:C-1
Practice Address - City:MAUMEE
Practice Address - State:OH
Practice Address - Zip Code:43537-3766
Practice Address - Country:US
Practice Address - Phone:419-893-3003
Practice Address - Fax:419-893-0475
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4188101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health