Provider Demographics
NPI:1972654325
Name:DENNINGS, BRUCE ELDON (PH,D)
Entity type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:ELDON
Last Name:DENNINGS
Suffix:
Gender:M
Credentials:PH,D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2112 BIENVILLE BLVD
Mailing Address - Street 2:SUITE O-1
Mailing Address - City:OCEAN SPRINGS
Mailing Address - State:MS
Mailing Address - Zip Code:39564-3052
Mailing Address - Country:US
Mailing Address - Phone:228-875-8440
Mailing Address - Fax:228-875-8443
Practice Address - Street 1:2112 BIENVILLE BLVD
Practice Address - Street 2:SUITE O-1
Practice Address - City:OCEAN SPRINGS
Practice Address - State:MS
Practice Address - Zip Code:39564-3052
Practice Address - Country:US
Practice Address - Phone:228-875-8440
Practice Address - Fax:228-875-8443
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS55 308103T00000X
103TC1900X, 103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Not Answered103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent