Provider Demographics
NPI:1396389920
Name:DENSON, AGNES L (MS)
Entity type:Individual
Prefix:MS
First Name:AGNES
Middle Name:L
Last Name:DENSON
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 KENON LN
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:FL
Mailing Address - Zip Code:32352-6924
Mailing Address - Country:US
Mailing Address - Phone:850-518-0710
Mailing Address - Fax:
Practice Address - Street 1:66 KENON LN
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:FL
Practice Address - Zip Code:32352-6924
Practice Address - Country:US
Practice Address - Phone:850-518-0710
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-06
Last Update Date:2019-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor