Individual
JULIA A BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
814 CONESTOGA DR, MANCHESTER, MO 63021-7510
(309) 256-7213
(309) 655-4609
Mailing address
814 CONESTOGA DR, MANCHESTER, MO 63021-7510
(130) 925-6721
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149-011730
IL
Other
Enumeration date
12/27/2007
Last updated
03/12/2022
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