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Individual

DENISE BENNETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.S., BCBA

Contact information

Practice address
3113 S 4TH ST, SPRINGFIELD, IL 62703-4011
(217) 622-1148
Mailing address
3113 S 4TH ST, SPRINGFIELD, IL 62703-4011

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary

Other

Enumeration date
02/19/2010
Last updated
12/08/2016
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