Individual
MARY BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
30 WARREN ST, BRIGHTON, MA 02135-3602
(617) 254-3800
Mailing address
30 WARREN ST, BRIGHTON, MA 02135-3602
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
220425
MA
Other
Enumeration date
04/24/2015
Last updated
04/24/2015
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