Individual
MARTHA ANNE BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
236 5TH AVE STE 404, NEW YORK, NY 10001-7606
(908) 248-2606
Mailing address
236 5TH AVE STE 404, NEW YORK, NY 10001-7606
(908) 248-2606
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
021421
NY
Other
Enumeration date
10/20/2015
Last updated
08/29/2019
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