Individual
CORY BRAD DENNIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD, LCSW
Contact information
Practice address
2179 JFSB, BRIGHAM YOUNG UNIVERSITY, PROVO, UT 84602
(801) 422-7447
Mailing address
2179 JFSB, BRIGHAM YOUNG UNIVERSITY, PROVO, UT 84602
(518) 956-1901
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
5947893-3501
UT
Other
Enumeration date
04/07/2010
Last updated
04/27/2017
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