Individual
MICHAEL BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
80 CODELL DR STE 230, LEXINGTON, KY 40509-1178
(859) 309-2877
Mailing address
204 N. LEXINGTON AVE, WILMORE, KS 40390
(904) 568-0838
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
278538
KY
Other
Enumeration date
10/14/2019
Last updated
05/01/2024
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