Individual
BIANCA BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
18001 N 79TH AVE STE B20, GLENDALE, AZ 85308-8390
(602) 570-7898
Mailing address
18001 N 79TH AVE STE B20, GLENDALE, AZ 85308-8390
(602) 570-7898
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LAC-22861
AZ
Other
Enumeration date
04/10/2025
Last updated
04/10/2025
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