Individual
ASHLEY BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MAADC1
Contact information
Practice address
2919 E 4TH ST, JOPLIN, MO 64801-1625
(417) 782-7966
(417) 624-4558
Mailing address
2919 E 4TH ST, JOPLIN, MO 64801-1625
(417) 782-7966
(417) 624-4558
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
10712
MO
Other
Enumeration date
06/13/2018
Last updated
06/13/2018
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