Individual
COURTNEY A BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACMHC
Contact information
Practice address
3307 19TH AVE, FOREST GROVE, OR 97116-1909
(503) 560-5822
Mailing address
2721 STRASBURG DR, FOREST GROVE, OR 97116-2252
(208) 240-3751
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
11332443-6009
UT
Other
Enumeration date
06/08/2019
Last updated
08/23/2024
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