Individual
ELIZABETH BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10 SOUTHWOOD DR, EDGEWOOD, NM 87015-7100
(405) 905-0881
Mailing address
9930 N EL UNO MINOR, TUCSON, AZ 85743-9788
(140) 590-5088
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-20-44478
—
106S00000X
Behavior Technician
—
—
Other
Enumeration date
09/06/2018
Last updated
02/23/2022
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