Individual
ERIC BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
800 N MAIN ST, MALTA, OH 43758-9019
(304) 916-8468
Mailing address
81 TOWNSHIP ROAD 349, IRONTON, OH 45638-8617
(740) 442-7706
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDCA.166859
OH
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
04/23/2018
Last updated
04/23/2018
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