Individual
DR. DANELLE MARIE CARRILLO BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
18201 CONNEAUT LAKE RD, MEADVILLE, PA 16335-3757
(814) 333-5061
(814) 333-5067
Mailing address
18201 CONNEAUT LAKE RD, MEADVILLE, PA 16335-3757
(814) 333-5061
(814) 333-5067
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
PC005567
PA
103T00000X
Psychologist
Primary
PS017424
PA
Other
Enumeration date
08/31/2010
Last updated
08/15/2013
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