Individual
DR. LORI BETH BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D./PH.D.
Contact information
Practice address
301 DEINHARD LN, MCCALL, ID 83638-4703
(208) 630-2450
(208) 634-4055
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-8752
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
266363
NY
2084P0800X
Psychiatry Physician
Primary
M-14694
ID
2084P0802X
Addiction Psychiatry Physician
266363
NY
Other
Enumeration date
05/04/2011
Last updated
04/24/2024
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