| Doctor Name: | MS. SAMANTHA BENNETT |
| NPI Number: | 1396932331 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 204 W Highland Ave Robinson, IL - 624541710 |
| Business Phone Number: | 6185461021 |
| Business Fax Number: | 6185447892 |
| Mailing Address: | Po Box M, 504 Micah Drive OLNEY |
| State: | IL |
| Postal Code: | 624500913 |
| Phone Number: | 6183954306 |
| Fax Number: | 6183954507 |
| NPI Enumeration Date: | 10/03/2007 |
| NPI Last Update Date: | 10/03/2007 |
| 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: | |