Individual
CHALEAH JAMIECE BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
875 E COLUMBUS ST, KENTON, OH 43326-2601
(937) 977-3340
Mailing address
875 E COLUMBUS ST, KENTON, OH 43326-2601
(937) 977-3340
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
175T00000X
Peer Specialist
Primary
005495
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0108657
—
OH
05
—
0109274
—
OH
Enumeration date
06/26/2023
Last updated
12/03/2025
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