Individual
DR. THOMAS OMER BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH. D.
Contact information
Practice address
50 MARKLEVILLE LN, WESTFIELD, IN 46074-8433
(317) 775-3711
Mailing address
50 MARKLEVILLE LN, WESTFIELD, IN 46074-8433
(317) 775-3711
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
20040100A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20040100A
103TC0700X - PSYCHOLOGIST - CLINICAL
IN
Enumeration date
06/28/2007
Last updated
09/10/2014
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