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Individual

BRADFORD S BENNETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
1701 N SENATE BLVD, RM AG022, INDIANAPOLIS, IN 46202-1239
(317) 962-2622
(317) 963-5424
Mailing address
250 N MERIDIAN ST, INDIANAPOLIS, IN 46219-4459
(317) 962-4942

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34005292
IN

Other

Enumeration date
01/05/2009
Last updated
01/27/2014
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