Individual
DR. J. MICHAEL DENNIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
311 N. ALLUMBAUGH ST., BOISE, ID 83704
(208) 375-6402
(208) 323-1850
Mailing address
311 N. ALLUMBAUGH ST., BOISE, ID 83704
(208) 375-6402
(208) 323-1850
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY371
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010008943
REGENCE BLUE SHIELD
—
01
—
N4809
BLUE CROSS OF IDAHO
ID
Enumeration date
06/20/2006
Last updated
11/16/2007
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