Individual
MR. MICHAEL MARTIN BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAC
Contact information
Practice address
75-377 HUALALAI RD, KAILUA KONA, HI 96740-9724
(808) 329-0774
(808) 329-0076
Mailing address
75-377 HUALALAI RD, KAILUA KONA, HI 96740-9724
(808) 329-0774
(808) 329-0076
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
667
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
667
LAC
MT
Enumeration date
10/27/2009
Last updated
10/27/2009
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