Individual
SAMANTHA BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
612 E BOULEVARD, KOKOMO, IN 46902-2271
(765) 461-1245
Mailing address
612 E BOULEVARD, KOKOMO, IN 46902-2271
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
01/27/2021
Last updated
01/27/2021
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