Individual
MARISSA L BENNERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
3304 COLORADO BLVD STE 102, DENTON, TX 76210-6872
(940) 484-4311
(940) 484-5075
Mailing address
PO BOX 99213, FORT WORTH, TX 76199-0213
(682) 885-1860
(682) 885-1396
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
38197
TX
Other
Enumeration date
09/22/2020
Last updated
09/22/2020
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