| Doctor Name: | MR. BENNETT EDWARD MOEHL |
| NPI Number: | 1063674893 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.A. |
| License Number: | |
| Business Practice Address: | 91 Northwest Dr Plainville, CT - 060621534 |
| Business Phone Number: | 8607933500 |
| Business Fax Number: | |
| Mailing Address: | 371 Brewster Rd, BRISTOL |
| State: | CT |
| Postal Code: | 06010 |
| Phone Number: | 8609067006 |
| Fax Number: | |
| NPI Enumeration Date: | 07/02/2008 |
| NPI Last Update Date: | 07/02/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |