Individual
PAIGE MADISON BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
7777 FOREST LN STE C833, DALLAS, TX 75230-2591
(972) 566-4591
Mailing address
3223 LEMMON AVE APT 3117, DALLAS, TX 75204-1828
(513) 504-6255
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
1062377
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/03/2021
Last updated
02/18/2022
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