Provider Demographics
NPI:1538900550
Name:DENNIS, BROOKE ERIN
Entity type:Individual
Prefix:
First Name:BROOKE
Middle Name:ERIN
Last Name:DENNIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:274 WASHINGTON ST APT 1L
Mailing Address - Street 2:
Mailing Address - City:MARBLEHEAD
Mailing Address - State:MA
Mailing Address - Zip Code:01945-3392
Mailing Address - Country:US
Mailing Address - Phone:407-405-0060
Mailing Address - Fax:
Practice Address - Street 1:142P CANAL ST
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-4650
Practice Address - Country:US
Practice Address - Phone:978-548-6288
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-04
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health