Individual
LAURA BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
1010 2ND AVE S, FARGO, ND 58103-8226
(701) 239-6786
(701) 241-5775
Mailing address
1010 2ND AVE S, FARGO, ND 58103-8226
(701) 239-6786
(701) 241-5775
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
4157
ND
Other
Enumeration date
06/13/2014
Last updated
06/13/2014
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