Individual
ESTELLA CAROLYN BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
IECE TEACHER
Contact information
Practice address
2070 WHITE ROSE RD, CAMPBELLSVILLE, KY 42718-6944
(270) 465-6521
Mailing address
2070 WHITE ROSE RD, CAMPBELLSVILLE, KY 42718-6944
(270) 465-6521
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
000017863
KY
Other
Enumeration date
09/14/2012
Last updated
09/14/2012
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