Individual
BRIANNE KAY BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BA
Contact information
Practice address
19420 N 59TH AVE STE C253, GLENDALE, AZ 85308-6897
(623) 934-9191
Mailing address
19420 N 59TH AVE STE C253, GLENDALE, AZ 85308-6897
(623) 934-9191
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC-24920
AZ
106S00000X
Behavior Technician
Primary
RBT-20-116541
AZ
Other
Enumeration date
08/19/2020
Last updated
06/12/2026
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