Individual
TAYLOR FAITH BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
429 N UNION AVE, SHAWNEE, OK 74801-7064
(405) 275-1844
(405) 275-1124
Mailing address
429 N UNION AVE, SHAWNEE, OK 74801-7064
(405) 275-1844
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
—
—
175T00000X
Peer Specialist
—
—
Other
Enumeration date
04/24/2023
Last updated
11/15/2023
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