Individual
DIANE L BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
15300 WEST AVE, SUITE 313, ORLAND PARK, IL 60462-4600
(708) 460-2721
Mailing address
15300 WEST AVE, SUITE 313, ORLAND PARK, IL 60462-4600
(708) 460-2721
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149-007415
IL
Other
Enumeration date
06/14/2012
Last updated
06/14/2012
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