Provider Demographics
NPI:1710454616
Name:DENNY, DAVID BEN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:BEN
Last Name:DENNY
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 1:1430 N EAGLE VIEW DR
Mailing Address - Street 2:
Mailing Address - City:COTTONWOOD
Mailing Address - State:AZ
Mailing Address - Zip Code:86326-6133
Mailing Address - Country:US
Mailing Address - Phone:406-570-3908
Mailing Address - Fax:
Practice Address - Street 1:661 E HOWARDS RD STE B2
Practice Address - Street 2:
Practice Address - City:CAMP VERDE
Practice Address - State:AZ
Practice Address - Zip Code:86322-6521
Practice Address - Country:US
Practice Address - Phone:406-570-3908
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-29
Last Update Date:2018-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZPSY-005039103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZPSY-005039OtherARIZONA STATE BOARD OF PSYCHOLOGIST EXAMINERS