Provider Demographics
NPI:1174960009
Name:DENNIS, JOSEPH RAYMOND
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:RAYMOND
Last Name:DENNIS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1172 E 100 N
Mailing Address - Street 2:SUITE 9
Mailing Address - City:PAYSON
Mailing Address - State:UT
Mailing Address - Zip Code:84651-1667
Mailing Address - Country:US
Mailing Address - Phone:801-477-0532
Mailing Address - Fax:
Practice Address - Street 1:1172 E 100 N
Practice Address - Street 2:SUITE 9
Practice Address - City:PAYSON
Practice Address - State:UT
Practice Address - Zip Code:84651-1667
Practice Address - Country:US
Practice Address - Phone:801-477-0532
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-01
Last Update Date:2013-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health