Provider Demographics
NPI:1457925687
Name:PENDLETON, DIONNE (PHD)
Entity Type:Individual
Prefix:DR
First Name:DIONNE
Middle Name:
Last Name:PENDLETON
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 1:8715 165TH ST APT 2K
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432-3515
Mailing Address - Country:US
Mailing Address - Phone:718-216-1462
Mailing Address - Fax:
Practice Address - Street 1:8715 165TH ST APT 2K
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-3515
Practice Address - Country:US
Practice Address - Phone:718-216-1462
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-12
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional