Individual
STACIE BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
401 RIDGE RD, DAYTON, NJ 08810-3300
(732) 230-3076
(866) 862-4631
Mailing address
11 HEATHER LN, BLOOMINGDALE, NJ 07403-1507
(570) 573-9103
(570) 573-9103
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
41YS00655500
NJ
Other
Enumeration date
06/21/2012
Last updated
09/09/2024
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