Individual
COLIN BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
1234 S POWER RD STE 100, MESA, AZ 85206-3740
(602) 633-5032
Mailing address
1234 S POWER RD STE 100, MESA, AZ 85206-3740
(602) 633-5032
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC-23194
AZ
Other
Enumeration date
05/25/2020
Last updated
07/10/2024
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