Individual
RHONDA LYNETTE BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
15 NAVARRE BLVD., THOREAU, NM 87323-1017
(505) 862-7417
Mailing address
PO BOX 1017, THOREAU, NM 87323-1017
(505) 862-7417
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
CMH0198691
NM
101YP2500X
Professional Counselor
Primary
CTB-2023-1043
NM
103K00000X
Behavior Analyst
—
—
Other
Enumeration date
01/05/2015
Last updated
01/02/2024
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