Individual
MRS. MARISSA J BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
9693 GRISSOM DR, MIDWEST CITY, OK 73130-3531
(405) 550-0286
Mailing address
9693 GRISSOM DR, MIDWEST CITY, OK 73130-3531
(405) 550-0286
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
02/05/2009
Last updated
07/15/2011
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