Individual
DR. JILL MARIE BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
511 W 1ST ST, MOUNT PLEASANT, TX 75455-4336
(903) 575-1330
(903) 577-9156
Mailing address
PO BOX 1866, MOUNT PLEASANT, TX 75456-1866
(903) 575-1330
(903) 577-9156
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
20261
TX
106H00000X
Marriage & Family Therapist
201003
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1796567-01
—
TX
Enumeration date
06/23/2009
Last updated
06/23/2009
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