Provider Demographics
NPI:1417685710
Name:DENNIS, SABRINA SHONTA
Entity Type:Individual
Prefix:
First Name:SABRINA
Middle Name:SHONTA
Last Name:DENNIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 HARVEY ST NE
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:GA
Mailing Address - Zip Code:30161-5159
Mailing Address - Country:US
Mailing Address - Phone:706-252-2045
Mailing Address - Fax:
Practice Address - Street 1:30 HARVEY ST NE
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:GA
Practice Address - Zip Code:30161-5159
Practice Address - Country:US
Practice Address - Phone:706-252-2045
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-13
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No172A00000XOther Service ProvidersDriver