Individual
MR. RALPH PARMENTER BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW LICSW
Contact information
Practice address
VA MEDICAL CTR, 215 NORTH MAIN ST, WHITE RIVER JUNCTION, VT 05009-0001
(802) 295-9363
Mailing address
PO BOX 5426, HANOVER, NH 03755-5426
(603) 568-5213
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
107397
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107397
LIC INDEP CLIN SOC WORKER
MA
Enumeration date
03/14/2007
Last updated
07/08/2007
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