Individual
DR. BRAD BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7325 STATE ROUTE 5, CLINTON, NY 13323-3435
(315) 859-1973
Mailing address
7325 STATE ROUTE 5, CLINTON, NY 13323-3435
(315) 859-1973
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
8120
NY
Other
Enumeration date
10/02/2006
Last updated
07/08/2007
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