Individual
BETHANY BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
31 CRESCENT HILLS DR, SAINT PETERS, MO 63376-4435
(636) 579-9476
Mailing address
31 CRESCENT HILLS DR, SAINT PETERS, MO 63376-4435
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2011005432
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2011005432
STATE OF MO
MO
Enumeration date
06/06/2022
Last updated
06/06/2022
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