Individual
KIMBERLY BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
765 ALLENS AVE, SUITE 102, PROVIDENCE, RI 02905-5443
(401) 490-8900
(401) 490-2619
Mailing address
765 ALLENS AVE, SUITE 102, PROVIDENCE, RI 02905-5443
(401) 490-8900
(401) 490-2619
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
ISW01954
RI
Other
Enumeration date
01/29/2009
Last updated
01/29/2009
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