Individual
CHERYL BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LMHC, LCAC
Contact information
Practice address
1720 BEACON ST, FORT WAYNE, IN 46805-4749
(260) 373-8000
(260) 373-8034
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
39001566A
IN
Other
Enumeration date
07/07/2007
Last updated
06/20/2023
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