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Individual

DEADRA DENNIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2816 CALICO ROCK CV, SOUTHAVEN, MS 38672
(901) 483-3741
Mailing address
2816 CALICO ROCK CV, SOUTHAVEN, MS 38672-8014
(901) 483-3741

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary

Other

Enumeration date
10/27/2015
Last updated
10/27/2015
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