Provider Demographics
NPI:1649572108
Name:DENNERY, ANNA JANE
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:JANE
Last Name:DENNERY
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 1:108 S 16TH ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19102-2802
Mailing Address - Country:US
Mailing Address - Phone:215-563-2402
Mailing Address - Fax:215-563-2135
Practice Address - Street 1:108 S 16TH ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19102-2802
Practice Address - Country:US
Practice Address - Phone:215-563-2402
Practice Address - Fax:215-563-2135
Is Sole Proprietor?:No
Enumeration Date:2010-12-03
Last Update Date:2010-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAF03403237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist