Individual
MS. MYRA WOOD BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
206 W 5TH ST, METROPOLIS, IL 62960-1810
(618) 524-9368
Mailing address
206 W 5TH ST, METROPOLIS, IL 62960-1810
(618) 524-9368
Taxonomy
Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary
1290403
IL
Other
Enumeration date
03/08/2017
Last updated
03/08/2017
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