Individual
MISS STACY MARIE BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CAC, BS
Contact information
Practice address
1314 N LAFITTE RD, ABBEVILLE, LA 70510-3149
(337) 600-1121
Mailing address
112 CALYPSO LN APT A, LAFAYETTE, LA 70508-9107
(337) 983-6328
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008101225
—
LA
Enumeration date
10/08/2020
Last updated
02/28/2023
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