Individual
DR. THOMAS CARL DENNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MCSP
Contact information
Practice address
ONE BAKER PLACE, MINERAL COUINTY BOARD OF EDUCATION, KEYSER, WV 26726
(304) 788-4200
Mailing address
39 MAPLE AVE, KEYSER, WV 26726-3308
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
15158
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0166075000
—
WV
Enumeration date
07/07/2008
Last updated
07/07/2008
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