Individual
ELIZABETH BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1 MARCUS DR STE 308, GREENVILLE, SC 29615-6946
(864) 631-2084
Mailing address
PO BOX 931142, ATLANTA, GA 31193-1142
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-23-294563
SC
Other
Enumeration date
09/20/2023
Last updated
09/20/2023
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