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Individual

TANYA WATT DENNIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MSW CSW

Contact information

Practice address
2718 E LAFAYETTE ST APT 204, DETROIT, MI 48207-3963
(248) 559-1763
Mailing address
2718 E LAFAYETTE ST APT 204, DETROIT, MI 48207-3963
(248) 559-1763

Taxonomy

Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
Primary
6801068072
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
6801068072
STATE LIC
MA
Enumeration date
07/18/2006
Last updated
07/08/2007
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