Provider Demographics
NPI:1164795191
Name:DENHAM, ANNE (EDS)
Entity Type:Individual
Prefix:MS
First Name:ANNE
Middle Name:
Last Name:DENHAM
Suffix:
Gender:F
Credentials:EDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8112 KY HIGHWAY 11
Mailing Address - Street 2:
Mailing Address - City:MAYSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41056-8428
Mailing Address - Country:US
Mailing Address - Phone:606-759-5706
Mailing Address - Fax:
Practice Address - Street 1:8112 KY HIGHWAY 11
Practice Address - Street 2:
Practice Address - City:MAYSVILLE
Practice Address - State:KY
Practice Address - Zip Code:41056-8428
Practice Address - Country:US
Practice Address - Phone:606-759-5706
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-22
Last Update Date:2012-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY000048176/KIE222Q00000X
KYED.S. DEGREE (UK)225CA2400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
No225CA2400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation CounselorAssistive Technology Practitioner