Individual
ANGELA BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4514 SAGE LN, MELISSA, TX 75454-0754
(702) 904-0869
Mailing address
4514 SAGE LN, MELISSA, TX 75454-0754
(702) 904-0869
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
106916
CA
1041C0700X
Clinical Social Worker
Primary
107446
TX
1041C0700X
Clinical Social Worker
9956-M
NV
1041C0700X
Clinical Social Worker
LMSW-20388
AZ
Other
Enumeration date
06/28/2022
Last updated
06/28/2022
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