Provider Demographics
NPI:1437674314
Name:HEATHER DALTON DENNIS, M.A., LPC, PLLC
Entity Type:Organization
Organization Name:HEATHER DALTON DENNIS, M.A., LPC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPC
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:DALTON DENNIS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:432-438-9428
Mailing Address - Street 1:4210 48TH ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79413-3714
Mailing Address - Country:US
Mailing Address - Phone:432-438-9428
Mailing Address - Fax:
Practice Address - Street 1:4210 48TH ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79413-3714
Practice Address - Country:US
Practice Address - Phone:432-438-9428
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)