Provider Demographics
NPI:1063627792
Name:HENCY, DEAN CHARLES (BSW)
Entity type:Individual
Prefix:MR
First Name:DEAN
Middle Name:CHARLES
Last Name:HENCY
Suffix:
Gender:M
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 HURON AVE
Mailing Address - Street 2:
Mailing Address - City:PORT HURON
Mailing Address - State:MI
Mailing Address - Zip Code:48060-3822
Mailing Address - Country:US
Mailing Address - Phone:810-966-4474
Mailing Address - Fax:810-985-9498
Practice Address - Street 1:230 HURON AVE
Practice Address - Street 2:
Practice Address - City:PORT HURON
Practice Address - State:MI
Practice Address - Zip Code:48060-3822
Practice Address - Country:US
Practice Address - Phone:810-966-4474
Practice Address - Fax:810-985-9498
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist