Provider Demographics
NPI:1598912008
Name:DENNANY, ASHLEY (EDS, NCSP)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:DENNANY
Suffix:
Gender:F
Credentials:EDS, NCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4465 E PARADISE VILLAGE PKWY S
Mailing Address - Street 2:#1158
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-7766
Mailing Address - Country:US
Mailing Address - Phone:520-245-6760
Mailing Address - Fax:
Practice Address - Street 1:4465 E PARADISE VILLAGE PKWY S
Practice Address - Street 2:#1158
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-7766
Practice Address - Country:US
Practice Address - Phone:520-245-6760
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-26
Last Update Date:2008-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3952485103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool