Individual
BENTON KENNING STEWART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.A.
Contact information
Practice address
1803 N JACKSON ST, TULLAHOMA, TN 37388-2201
(931) 461-1340
(931) 461-1303
Mailing address
96 MOTLOW CT, WARTRACE, TN 37183-8024
(931) 461-0314
(931) 461-1303
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
PE1033
TN
Other
Enumeration date
03/09/2007
Last updated
07/08/2007
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