Provider Demographics
NPI:1215813902
Name:DENNIS, DUSTI LYN
Entity type:Individual
Prefix:MISS
First Name:DUSTI
Middle Name:LYN
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 1:635 E 600 S
Mailing Address - Street 2:
Mailing Address - City:PRICE
Mailing Address - State:UT
Mailing Address - Zip Code:84501-3304
Mailing Address - Country:US
Mailing Address - Phone:435-650-7684
Mailing Address - Fax:
Practice Address - Street 1:10 W BROADWAY STE BROADWAY
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84101-2002
Practice Address - Country:US
Practice Address - Phone:385-494-3500
Practice Address - Fax:385-494-3503
Is Sole Proprietor?:No
Enumeration Date:2025-08-15
Last Update Date:2025-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician