Individual
DR. BENNETT EDGERLY
Active
Individual
DR. BENNETT EDGERLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D., LPC
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC.0016208
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LPC-15634
ARIZONA LICENSE
AZ
01
—
LPC.0016208
STATE LICENSING BOARD OF COLORADO
CO
Enumeration date
08/08/2017
Last updated
07/25/2023
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