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Individual

MARY G. BENNETT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
4 N SAN FRANCISCO ST, STE D, FLAGSTAFF, AZ 86001-5230
(926) 600-4626
(928) 526-1182
Mailing address
4 N SAN FRANCISCO ST, STE D, FLAGSTAFF, AZ 86001-5230
(926) 600-4626
(928) 526-1182

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC-2467
AZ

Other

Enumeration date
12/04/2006
Last updated
07/08/2007
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