Provider Demographics
NPI:1740603216
Name:WILLIAMSON, DENNIS I (MED)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:
Last Name:WILLIAMSON
Suffix:I
Gender:M
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:136 E PITT ST
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15522-1347
Mailing Address - Country:US
Mailing Address - Phone:814-285-7771
Mailing Address - Fax:814-266-1462
Practice Address - Street 1:136 E PITT ST
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:PA
Practice Address - Zip Code:15522-1347
Practice Address - Country:US
Practice Address - Phone:814-285-7771
Practice Address - Fax:814-266-1462
Is Sole Proprietor?:No
Enumeration Date:2014-02-03
Last Update Date:2014-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA251779079101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor