Individual
ELISABETH BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CTRS
Contact information
Practice address
613 WINIFRED RD, LEESBURG, GA 31763-5342
(229) 894-9170
Mailing address
613 WINIFRED RD, LEESBURG, GA 31763-5342
(229) 894-9170
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
86544
GA
Other
Enumeration date
03/20/2025
Last updated
03/20/2025
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