Individual
CLARISSA BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA CCC-SLP
Contact information
Practice address
2016 DOBSON ROAD, BLYTHEWOOD, SC 29016
(803) 714-5644
Mailing address
449 RIMER POND RD, BLYTHEWOOD, SC 29016-9155
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3657
SC
Other
Enumeration date
03/29/2007
Last updated
07/08/2007
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