Individual
JEFFREY E BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMFT
Contact information
Practice address
4722 TAFT BLVD STE 2, WICHITA FALLS, TX 76308-4800
(940) 691-1899
(940) 691-3423
Mailing address
4722 TAFT BLVD STE 2, WICHITA FALLS, TX 76308-4800
(940) 691-1899
(940) 691-3423
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
3347
TX
106H00000X
Marriage & Family Therapist
Primary
3347
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
028976103
—
TX
01
—
8071BH
BLUE CROSS ID NUMBER
TX
Enumeration date
02/20/2007
Last updated
11/06/2018
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