Individual
ELLA ANNE BENTLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LADAC
Contact information
Practice address
125 S KING AVE, DYERSBURG, TN 38024-4614
(731) 287-8100
Mailing address
510 BEAVER CREEK CV, DYERSBURG, TN 38024-7412
(731) 445-0112
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
999
TN
Other
Enumeration date
05/10/2012
Last updated
05/10/2012
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