Individual
MS. MARLO KATHLEEN BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
1901 PROSPECTOR AVE STE 22, PARK CITY, UT 84060-7208
(435) 901-3218
Mailing address
1901 PROSPECTOR AVENUE, STE 22, PARK CITY, UT 84060
(435) 901-3218
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
357426-3902
UT
101YM0800X
Mental Health Counselor
Primary
357426-3902
UT
106H00000X
Marriage & Family Therapist
357426-3902
UT
Other
Enumeration date
01/27/2006
Last updated
08/29/2019
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