Provider Demographics
NPI:1972522290
Name:DENNEHY, DENISE TOBIN (RD)
Entity Type:Individual
Prefix:MS
First Name:DENISE
Middle Name:TOBIN
Last Name:DENNEHY
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:22151 MOROSS RD
Mailing Address - Street 2:PBI SUITE 134
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48236-2167
Mailing Address - Country:US
Mailing Address - Phone:313-343-6877
Mailing Address - Fax:313-417-0527
Practice Address - Street 1:22151 MOROSS RD
Practice Address - Street 2:PBI SUITE 134
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48236-2167
Practice Address - Country:US
Practice Address - Phone:313-343-6877
Practice Address - Fax:313-417-0527
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered