Individual
JANICE LEIGH ANNE BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED CCC-SLP
Contact information
Practice address
1205 BELLEVUE AVE, SUITE H, DUBLIN, GA 31021-4155
(478) 272-2100
(478) 272-2005
Mailing address
1006 SCOTLAND RD, RENTZ, GA 31075-3316
(478) 272-2100
(478) 272-2005
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP007724
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003126629A
—
GA
01
—
1770843948
NPI GROUP
GA
Enumeration date
10/24/2011
Last updated
08/14/2013
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