Provider Demographics
NPI:1447762869
Name:HANNON, DENNIS (PSYD)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:
Last Name:HANNON
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4317 UPTON AVE S STE A
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55410-1540
Mailing Address - Country:US
Mailing Address - Phone:952-222-8162
Mailing Address - Fax:
Practice Address - Street 1:4317 UPTON AVE S STE A
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55410-1540
Practice Address - Country:US
Practice Address - Phone:952-222-8162
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-25
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist