Individual
MR. DAVID LOUIS BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3007 KNIGHT ST., SUITE 200, SHREVEPORT, LA 71105
(318) 221-8244
(318) 861-2162
Mailing address
3007 KNIGHT ST STE 200, SHREVEPORT, LA 71105-2525
(318) 221-8244
(318) 861-2162
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
72-0694376
—
LA
Enumeration date
09/27/2017
Last updated
07/21/2022
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