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Individual

MRS. CYNTHIA MATA BENNETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LBSW-IPR

Contact information

Practice address
871 OLD ALICE RD, SUITE 600 C, BROWNSVILLE, TX 78520-8268
(956) 541-2102
(956) 541-2502
Mailing address
5336 WILLOW BND, BROWNSVILLE, TX 78526-1269
(956) 371-2024

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
37620
TX
171M00000X
Case Manager/Care Coordinator
37620
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
178836801
TX
Enumeration date
10/20/2006
Last updated
02/14/2013
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