Individual
JACQUELINE BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ADD
Contact information
Practice address
821 HOWARD RD SE, WASHINGTON, DC 20020-5805
(202) 698-2616
Mailing address
821 HOWARD RD SE, WASHINGTON, DC 20020-5805
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
ADD13906
DC
Other
Enumeration date
07/21/2008
Last updated
07/21/2008
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