Individual
MICHAEL ADAM DENNIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
3010 E STATE BLVD, FORT WAYNE, IN 46805-4700
(260) 471-2300
Mailing address
9531 VALPARAISO CT, INDIANAPOLIS, IN 46268-1130
(317) 329-2000
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
NA
IN
Other
Enumeration date
08/05/2007
Last updated
08/31/2018
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