Individual
MARY ALISON BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
600 ARTHUR ST, KNOXVILLE, TN 37921-6405
(865) 523-8695
Mailing address
200 TECH CENTER DR, KNOXVILLE, TN 37912-2747
(865) 637-9711
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
RBT-21-186317
TN
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RBT-21-186317
BACB
TN
Enumeration date
11/19/2021
Last updated
07/19/2022
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