Individual
NOMI-KAIE BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
136 PARKWAY DR, COBLESKILL, NY 12043-5150
(518) 234-2555
Mailing address
122 CLINTON CIR, COBLESKILL, NY 12043-4110
(518) 364-9472
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
022857-1
NY
Other
Enumeration date
10/09/2018
Last updated
10/09/2018
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