Individual
MRS. JENNIFER BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC-SLP, NC BOESLP
Contact information
Practice address
110 SECRET ROAD, RALEIGH, NC 27699-4128
(919) 725-1232
Mailing address
5448 APEX PEAKWAY DR, PO BOX 200, APEX, NC 27502
(555) 555-5555
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
12250
NC
Other
Enumeration date
01/30/2017
Last updated
07/01/2024
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