Individual
MS. NANCY J BENNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
9860 SW HALL BLVD, SUITE D, TIGARD, OR 97223-8896
(503) 516-3368
Mailing address
PO BOX 80956, PORTLAND, OR 97280-1956
(503) 516-3368
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L4333
OR
Other
Enumeration date
12/03/2008
Last updated
12/03/2008
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