Individual
ZAVA BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3048 S CLIFTON AVE, SPRINGFIELD, MO 65807-5957
(417) 818-5784
Mailing address
3048 S CLIFTON AVE, SPRINGFIELD, MO 65807-5957
(417) 818-5784
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT21153130
MO
Other
Enumeration date
03/31/2021
Last updated
03/31/2021
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