Provider Demographics
NPI:1396086617
Name:DENDY, ANNA K (PHD)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:K
Last Name:DENDY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25101 CHAGRIN BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-5643
Mailing Address - Country:US
Mailing Address - Phone:216-831-6611
Mailing Address - Fax:216-456-8128
Practice Address - Street 1:25101 CHAGRIN BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-5643
Practice Address - Country:US
Practice Address - Phone:216-831-6611
Practice Address - Fax:216-456-8128
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-12
Last Update Date:2015-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHP6983103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist