Individual
ROBERT BENNETT JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
193 CLARK ST APT 2, PORTLAND, ME 04102-3834
(207) 252-2124
Mailing address
193 CLARK ST APT 2, PORTLAND, ME 04102-3834
(207) 252-2124
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC23946
ME
Other
Enumeration date
09/03/2024
Last updated
09/03/2024
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