Individual
ELLEN D BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHP
Contact information
Practice address
444 S 44TH ST, OMAHA, NE 68131-3727
(402) 559-5741
(402) 559-5737
Mailing address
985450 NEBRASKA MEDICAL CTR, OMAHA, NE 68198-5450
(402) 559-8943
(402) 559-5737
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
9615
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025287200
—
NE
Enumeration date
03/05/2012
Last updated
03/05/2012
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