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Individual

JAMIE L BENNETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CDCA.169712

Contact information

Practice address
300 MORTON ST, JACKSON, OH 45640-1028
(740) 628-0178
Mailing address
300 MORTON ST, JACKSON, OH 45640-1028
(740) 628-0178

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
169712
OH

Other

Enumeration date
04/30/2019
Last updated
04/30/2019
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