Provider Demographics
NPI:1649427790
Name:HESS, DENA ANN (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:DENA
Middle Name:ANN
Last Name:HESS
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:MS
Other - First Name:DENA
Other - Middle Name:ANN
Other - Last Name:CARLTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:4284 FORDS BROOK RD.
Mailing Address - Street 2:N. BRANCH
Mailing Address - City:WELLSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14895-9797
Mailing Address - Country:US
Mailing Address - Phone:585-808-7115
Mailing Address - Fax:
Practice Address - Street 1:4284 FORDS BROOK RD.
Practice Address - Street 2:N. BRANCH
Practice Address - City:WELLSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14895-9797
Practice Address - Country:US
Practice Address - Phone:585-808-7115
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-20
Last Update Date:2021-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011364235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1649427790Medicaid