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Individual

SHAWN DYLAN DENNIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
410 GOLDSMITH AVE, MAMMOTH SPRING, AR 72554-8045
(417) 280-1247
(870) 341-6242
Mailing address
10282 PRIVATE ROAD 8829, WEST PLAINS, MO 65775-9400
(417) 280-1247
(870) 341-6242

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
AR
1041C0700X
Clinical Social Worker
Primary
8780-C
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
232264719
AR
Enumeration date
07/25/2018
Last updated
03/25/2024
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