Individual
MRS. CARLY VICTORIA BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS CCC-SLP
Contact information
Practice address
4101 ROXBURY CT, BOYNTON BEACH, FL 33436-9052
(954) 854-8612
Mailing address
4101 ROXBURY CT, BOYNTON BEACH, FL 33436-9052
(954) 854-8612
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA 8845
FL
Other
Enumeration date
06/05/2007
Last updated
07/08/2007
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