Individual
AMANDA BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
217 E OAK ST, KISSIMMEE, FL 34744-4503
(407) 219-0402
Mailing address
233 SIESTA VISTA CT, DAVENPORT, FL 33896-8635
(774) 454-7203
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/09/2023
Last updated
08/09/2023
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