Provider Demographics
NPI:1558406629
Name:BURNS, DENNIS J (EDD)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:J
Last Name:BURNS
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 1:371W LODGE DR
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283-3532
Mailing Address - Country:US
Mailing Address - Phone:602-574-9323
Mailing Address - Fax:
Practice Address - Street 1:371 W LODGE DR
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85283-3532
Practice Address - Country:US
Practice Address - Phone:602-574-9323
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2015-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3761103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist