Provider Demographics
NPI:1316204076
Name:DENNIS, MARCHELLA (BHRS)
Entity Type:Individual
Prefix:
First Name:MARCHELLA
Middle Name:
Last Name:DENNIS
Suffix:
Gender:F
Credentials:BHRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5601 NW 72ND ST STE 178J
Mailing Address - Street 2:
Mailing Address - City:WARR ACRES
Mailing Address - State:OK
Mailing Address - Zip Code:73132-5931
Mailing Address - Country:US
Mailing Address - Phone:405-905-7332
Mailing Address - Fax:
Practice Address - Street 1:5601 NW 72ND ST STE 178J
Practice Address - Street 2:
Practice Address - City:WARR ACRES
Practice Address - State:OK
Practice Address - Zip Code:73132-5931
Practice Address - Country:US
Practice Address - Phone:405-905-7332
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-19
Last Update Date:2021-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health