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Individual

KATIE BENNETT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
934 S MAIN ST, LAYTON, UT 84041-7135
(801) 336-1845
Mailing address
934 S MAIN ST, LAYTON, UT 84041-7135
(801) 773-7060

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
9582076-3501
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000055266
MEDICARE PIN
UT
01
260022408
RAILROAD MEDICARE
UT
05
8760003008007
UT
Enumeration date
02/13/2019
Last updated
03/26/2025
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