Provider Demographics
NPI:1245613322
Name:DENNEY, ROBERT L (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:L
Last Name:DENNEY
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4350 S NATIONAL AVE
Mailing Address - Street 2:SUITE B116
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65810-2607
Mailing Address - Country:US
Mailing Address - Phone:417-881-1810
Mailing Address - Fax:888-728-5456
Practice Address - Street 1:4350 S NATIONAL AVE
Practice Address - Street 2:SUITE B116
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65810-2607
Practice Address - Country:US
Practice Address - Phone:417-881-1810
Practice Address - Fax:888-728-5456
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-07
Last Update Date:2021-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103TF0200X
MOR0316103G00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical