Provider Demographics
NPI:1235599465
Name:DENNENY, ALYSSA
Entity Type:Individual
Prefix:MS
First Name:ALYSSA
Middle Name:
Last Name:DENNENY
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 1:3515 CADUCEUS DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29588-2922
Mailing Address - Country:US
Mailing Address - Phone:843-652-8350
Mailing Address - Fax:843-293-7364
Practice Address - Street 1:3515 CADUCEUS DR
Practice Address - Street 2:SUITE A
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29588-2922
Practice Address - Country:US
Practice Address - Phone:843-652-8350
Practice Address - Fax:843-293-7364
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-01
Last Update Date:2016-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist