Individual
PATRICE BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3817 WOODROW AVE, SHREVEPORT, LA 71109-4435
(318) 507-5789
Mailing address
3817 WOODROW AVE, SHREVEPORT, LA 71109-4435
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
11/30/2016
Last updated
11/30/2016
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