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Individual
MR. THOMAS W BENNETT I
Active
Individual
MR. THOMAS W BENNETT I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CDCA PRELIMINARY
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
189578
OH
175T00000X
Peer Specialist
APS006603
OH
Other
Enumeration date
08/19/2024
Last updated
04/03/2025
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