Individual
MICHELE BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4001 VIRGINIA BEACH BLVD STE 117-126, VIRGINIA BEACH, VA 23452-1759
(855) 832-6727
(772) 675-9100
Mailing address
7108 S KANNER HWY, STUART, FL 34997-7462
(855) 832-6727
(772) 675-9100
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
0133002709
VA
103K00000X
Behavior Analyst
10098
TX
103K00000X
Behavior Analyst
Primary
10217312
OR
Other
Enumeration date
11/27/2020
Last updated
05/21/2026
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