Provider Demographics
NPI:1407081110
Name:DENNIS, DARLENE A (MSW)
Entity Type:Individual
Prefix:MRS
First Name:DARLENE
Middle Name:A
Last Name:DENNIS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8304 S KALANCHOE AVE
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74011-7808
Mailing Address - Country:US
Mailing Address - Phone:918-392-1789
Mailing Address - Fax:918-394-2257
Practice Address - Street 1:8404 S KALANCHOE AVE
Practice Address - Street 2:
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74011-7810
Practice Address - Country:US
Practice Address - Phone:918-392-1789
Practice Address - Fax:918-394-2257
Is Sole Proprietor?:No
Enumeration Date:2009-05-26
Last Update Date:2009-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health