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Individual

DR. SHANNON BENNETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
715 W GAINES ST, TALLAHASSEE, FL 32306-1603
(850) 644-9926
(850) 644-6591
Mailing address
715 W GAINES ST, TALLAHASSEE, FL 32306-1603
(850) 644-9926
(850) 644-6591

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY 9086
FL
103TS0200X
School Psychologist
SS 1235
FL

Other

Enumeration date
03/13/2017
Last updated
03/13/2017
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