Individual
SIERRA BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CO 61034482
Contact information
Practice address
516 E 1ST ST, ABERDEEN, WA 98520-4106
(360) 350-4010
(360) 533-9825
Mailing address
516 E 1ST ST, ABERDEEN, WA 98520-4106
(360) 350-4010
(360) 533-9825
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CO61034482
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33-0652655
—
CA
Enumeration date
01/28/2020
Last updated
01/28/2020
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