| Doctor Name: | LESLIE LYNN BENNETT |
| NPI Number: | 1659558880 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW |
| License Number: | 574 |
| Business Practice Address: | Hwy 264 Mile Marker 388 Hopi Healthcare Center Polacca, AZ - 86042 |
| Business Phone Number: | 9287376188 |
| Business Fax Number: | 9287376098 |
| Mailing Address: | Po Box 631, POLACCA |
| State: | AZ |
| Postal Code: | 860420631 |
| Phone Number: | 9287376188 |
| Fax Number: | |
| NPI Enumeration Date: | 01/30/2008 |
| NPI Last Update Date: | 05/05/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 574 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AK |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |