Provider Demographics
NPI:1982244760
Name:DENTINGER, ALLISON BETHANY (MT-BC)
Entity Type:Individual
Prefix:MISS
First Name:ALLISON
Middle Name:BETHANY
Last Name:DENTINGER
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10675 COUNTY RD
Mailing Address - Street 2:
Mailing Address - City:CLARENCE
Mailing Address - State:NY
Mailing Address - Zip Code:14031-1038
Mailing Address - Country:US
Mailing Address - Phone:716-982-7398
Mailing Address - Fax:
Practice Address - Street 1:80 S MAIN ST
Practice Address - Street 2:
Practice Address - City:OAKFIELD
Practice Address - State:NY
Practice Address - Zip Code:14125-1241
Practice Address - Country:US
Practice Address - Phone:585-313-3265
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-09
Last Update Date:2020-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY15538225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist