Individual
AMY BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
135 BURLINGTON OVAL DR, CHARDON, OH 44024-1453
(440) 636-3937
Mailing address
135 BURLINGTON OVAL DR, CHARDON, OH 44024-1453
(440) 636-3937
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0159695
—
OH
Enumeration date
09/29/2020
Last updated
09/29/2020
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