Provider Demographics
NPI:1265676209
Name:DENNIS, CAROLE ANN (CCC/SLP)
Entity Type:Individual
Prefix:MS
First Name:CAROLE ANN
Middle Name:
Last Name:DENNIS
Suffix:
Gender:F
Credentials:CCC/SLP
Other - Prefix:
Other - First Name:CANDY
Other - Middle Name:
Other - Last Name:DENNIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4 PETER COOPER RD
Mailing Address - Street 2:APT. 4B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-6735
Mailing Address - Country:US
Mailing Address - Phone:212-260-5510
Mailing Address - Fax:917-591-8769
Practice Address - Street 1:4 PETER COOPER RD
Practice Address - Street 2:APT. 4B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-6735
Practice Address - Country:US
Practice Address - Phone:212-260-5510
Practice Address - Fax:917-591-8769
Is Sole Proprietor?:No
Enumeration Date:2009-04-21
Last Update Date:2009-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011699235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist