Individual
MS. MARLENE A DENNIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
135 W 50TH ST # W, NEW YORK, NY 10020-1201
(212) 304-1430
(718) 365-2777
Mailing address
10325 168TH PL, JAMAICA, NY 11433-1727
(917) 288-8736
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
320800000X
NY
Other
Enumeration date
10/14/2011
Last updated
10/14/2011
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