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Organization

SOULTENDERS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CAROL BENNETT (MFC THERAPIST)
(626) 737-1742
Entity
Organization

Contact information

Practice address
41 E FOOTHILL BLVD, SUITE #102, ARCADIA, CA 91006-2361
(626) 737-1742
Mailing address
41 E FOOTHILL BLVD, SUITE #102, ARCADIA, CA 91006-2361
(626) 737-1742

Taxonomy

Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
46448
CA

Other

Enumeration date
01/16/2009
Last updated
01/16/2009
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