Individual
RONNIE BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1309 10TH AVE, GREELEY, CO 80631
(970) 347-2120
Mailing address
1300 N 17TH AVE, GREELEY, CO 80631-9584
(970) 347-2120
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LMFT-10336
AZ STATE LICENSE
AZ
Enumeration date
03/10/2015
Last updated
05/25/2018
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