Individual
ANNA L PRESPARE BENNETT
Active
Individual
ANNA L PRESPARE BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW-R
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
00076352
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000415214001
EMPIRE BC/BS BLUE CARD
—
05
—
00076352
—
NY
01
—
11645160
CAQH
—
01
—
53088
MVP
—
01
—
J400000216
MEDICARE SENIOR BLUE
—
Enumeration date
07/17/2006
Last updated
10/07/2011
Update your record
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