Doctor Name: | AMBER L BENNETT |
NPI Number: | 1255698023 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS MHC |
License Number: | |
Business Practice Address: | 185 Sherman Dr Suite 2 St Johnsbury, VT - 058199811 |
Business Phone Number: | 8027485174 |
Business Fax Number: | 8027484878 |
Mailing Address: | 165 Sherman Dr, ST JOHNSBURY |
State: | VT |
Postal Code: | 058199811 |
Phone Number: | 8027489405 |
Fax Number: | 8027484540 |
NPI Enumeration Date: | 04/18/2012 |
NPI Last Update Date: | 04/18/2012 |
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: |