Individual
RANDI BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
521 W 239TH ST, BRONX, NY 10463-1205
(718) 601-2280
Mailing address
408 W 49TH ST, APT. 2, NEW YORK, NY 10019-7289
(551) 206-1221
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
023244
NY
Other
Enumeration date
05/21/2014
Last updated
02/28/2020
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