Individual
DR. WANDA DENISE DENNIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
30100 TELEGRAPH RD, BINGHAM FARMS, MI 48025-4514
(248) 443-7021
Mailing address
1758 BRIDGEWATER DR, YPSILANTI, MI 48198-3280
(248) 872-5227
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301011636
MI
103TC0700X
Clinical Psychologist
PSY003531
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2055092
CIGNA
MI
01
—
VALUEOPTIONS
BCBC, BCN
MI
Enumeration date
07/12/2006
Last updated
10/03/2022
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