Individual
NICOLE BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3333 BURNET AVE, CINCINNATI, OH 45229-3026
(513) 636-4200
Mailing address
4044 HAVERSTRAW DR, CINCINNATI, OH 45241-2608
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
P.08327
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/24/2021
Last updated
01/31/2023
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