Provider Demographics
NPI:1346321056
Name:DENNIS, ROBERT STEVEN (PHD, CRC)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:STEVEN
Last Name:DENNIS
Suffix:
Gender:M
Credentials:PHD, CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 W NORMAN AVE
Mailing Address - Street 2:#1
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45405-3343
Mailing Address - Country:US
Mailing Address - Phone:937-268-6511
Mailing Address - Fax:937-262-5960
Practice Address - Street 1:4100 W 3RD ST
Practice Address - Street 2:BLDG 410, ROOM 322
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45428-9000
Practice Address - Country:US
Practice Address - Phone:937-268-6511
Practice Address - Fax:937-262-5960
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744R1102XOther Service ProvidersSpecialistResearch Study
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL00011703OtherCERTIFIED REHAB COUN