Individual
DR. DENNIS EDWIN WAITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ED.D.
Contact information
Practice address
5761 ORCHARD DR, BERRIEN SPRINGS, MI 49103-9683
(269) 471-5422
(269) 473-3261
Mailing address
PO BOX 339, BERRIEN SPRINGS, MI 49103-0339
(269) 471-5422
(269) 473-3261
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
6301006392
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0A1-4515
BLUE CROSS BLUE SHIELD
MI
Enumeration date
01/10/2007
Last updated
07/08/2007
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