Individual
HEATHER NICOLE BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4524 RUNNING W DR APT 203, GILLETTE, WY 82718-2060
(307) 299-3699
Mailing address
4524 RUNNING W DR APT 203, GILLETTE, WY 82718-2060
(307) 299-3699
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
171W00000X
Contractor
—
—
Other
Enumeration date
06/18/2018
Last updated
06/18/2018
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