Provider Demographics
NPI:1174662506
Name:DENNISON, BARBARA JO (PHD, LISW)
Entity Type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:JO
Last Name:DENNISON
Suffix:
Gender:F
Credentials:PHD, LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6111 DUFFY RD
Mailing Address - Street 2:
Mailing Address - City:DELAWARE
Mailing Address - State:OH
Mailing Address - Zip Code:43015-8200
Mailing Address - Country:US
Mailing Address - Phone:740-881-4383
Mailing Address - Fax:614-848-5323
Practice Address - Street 1:97 S LIBERTY ST
Practice Address - Street 2:
Practice Address - City:POWELL
Practice Address - State:OH
Practice Address - Zip Code:43065-9301
Practice Address - Country:US
Practice Address - Phone:614-888-8440
Practice Address - Fax:614-848-5323
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI00040891041C0700X
MI68010789131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical