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Individual

KRISTIE BENNETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CCC-SLP

Contact information

Practice address
1701 BOULEVARD SQ STE F, WAYCROSS, GA 31501-8022
(229) 469-6932
Mailing address
809 N PATTERSON ST, VALDOSTA, GA 31601-4528
(229) 469-6932

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP007166
GA

Other

Enumeration date
04/28/2020
Last updated
04/28/2020
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