Individual
ALLYSON DIANA BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
5001 WESTBANK EXPY, MARRERO, LA 70072-2922
(504) 349-8708
Mailing address
1514 JEFFERSON HWY, STE 213, NEW ORLEANS, LA 70121-2429
(504) 842-7715
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1130
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1364
—
LA
Enumeration date
10/17/2006
Last updated
04/29/2016
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