Individual
PHYLLESIA BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1353 E MAIN ST, BROWNSBURG, IN 46112-1433
(317) 294-5242
Mailing address
1353 E MAIN ST, BROWNSBURG, IN 46112-1433
(317) 294-5242
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
46003245A
IN
Other
Enumeration date
08/22/2017
Last updated
08/22/2017
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