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Individual

LESLIE BENNETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
272 NW MEDICAL LOOP STE C, ROSEBURG, OR 97471-5545
(541) 440-3532
(541) 440-3554
Mailing address
2700 NW STEWART PKWY, ANNEX A, ROSEBURG, OR 97471-1281
(541) 672-5667
(541) 672-1048

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
172V00000X
Community Health Worker
Primary

Other

Enumeration date
10/10/2008
Last updated
07/21/2022
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