Individual
DIANA WILDER-BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
115 ROCKWOOD LN, HAZARD, KY 41701-9415
(606) 436-5761
(606) 436-5797
Mailing address
115 ROCKWOOD LN, HAZARD, KY 41701-9415
(606) 436-5761
(606) 436-5797
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
1840
KY
Other
Enumeration date
12/20/2012
Last updated
05/01/2014
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