Individual
ANGELA SENAIDA BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1118 HAWAII AVE APT A, ALAMOGORDO, NM 88310-6441
(931) 809-0670
Mailing address
PO BOX 1038, ALAMOGORDO, NM 88311-1038
(931) 809-0670
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
12/03/2019
Last updated
12/03/2019
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