Individual
SHANNON MARIE BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
535 E 68TH ST, NEW YORK, NY 10065-4870
(888) 694-5700
Mailing address
450 E 63RD ST, APT 3K, NEW YORK, NY 10065-7928
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
Primary
018842
NY
Other
Enumeration date
11/01/2010
Last updated
11/01/2010
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