Provider Demographics
NPI:1902970817
Name:DENNEN, IRIS BRANDE (MED, LPC)
Entity Type:Individual
Prefix:MRS
First Name:IRIS
Middle Name:BRANDE
Last Name:DENNEN
Suffix:
Gender:F
Credentials:MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1578
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-8155
Mailing Address - Country:US
Mailing Address - Phone:214-733-4202
Mailing Address - Fax:214-585-0649
Practice Address - Street 1:1700 N REDBUD BLVD STE 316
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75069-3292
Practice Address - Country:US
Practice Address - Phone:214-733-4202
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16086101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX230436OtherMHN PROVIDER ID
TX1679070OtherCIGNA ID
TX6612LCOtherBCBS