Individual
DALE SHAUNE BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8002 CAREY BRANCH DR, FORT WASHINGTON, MD 20744-4427
(240) 432-6445
Mailing address
8002 CAREY BRANCH DR, FORT WASHINGTON, MD 20744-4427
(240) 432-6445
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
03/27/2023
Last updated
07/24/2023
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