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Individual

GINA BETH BENNETT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
2912 S DOUGLAS BLVD, SUITE A, MIDWEST CITY, OK 73130-7179
(405) 698-7399
Mailing address
450 ECHO LN, HARRAH, OK 73045-9654
(405) 698-7399

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
3593
OK

Other

Enumeration date
09/12/2010
Last updated
04/30/2017
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