Provider Demographics
NPI:1376776393
Name:DENNISON, ERIC DAVID (EDD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:DAVID
Last Name:DENNISON
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:717 12TH ST
Mailing Address - Street 2:SUITE 118
Mailing Address - City:BEAVER FALLS
Mailing Address - State:PA
Mailing Address - Zip Code:15010-4479
Mailing Address - Country:US
Mailing Address - Phone:724-843-4647
Mailing Address - Fax:724-843-8033
Practice Address - Street 1:717 12TH ST
Practice Address - Street 2:SUITE 118
Practice Address - City:BEAVER FALLS
Practice Address - State:PA
Practice Address - Zip Code:15010-4479
Practice Address - Country:US
Practice Address - Phone:724-843-4647
Practice Address - Fax:724-843-8033
Is Sole Proprietor?:No
Enumeration Date:2009-08-25
Last Update Date:2009-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral