Individual
JEANINE KAYE BENGTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
121 N SCHOOL AVE UNIT 1, FAYETTEVILLE, AR 72701-5132
(479) 530-4586
Mailing address
121 N SCHOOL AVE UNIT 1, FAYETTEVILLE, AR 72701-5132
(479) 530-4586
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3226-C
AR
Other
Enumeration date
06/16/2010
Last updated
09/03/2020
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