Individual
BRISEIDA N/A BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LMSW-P
Contact information
Practice address
1100 NE 13TH ST, OKLAHOMA CITY, OK 73117-1039
(405) 271-5700
Mailing address
1100 NE 13TH ST, OKLAHOMA CITY, OK 73117-1039
(405) 271-5700
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
20048
OK
Other
Enumeration date
05/19/2023
Last updated
05/19/2023
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