Gina Beth Bennett, LPC
Counselor, Professional in Midwest City, OK. Individual provider (NPI-1).
NPI number1992012983
StatusActive
Last updated in NPPESApr 30, 2017
Details
- NPI
- 1992012983
- Entity type
- Individual (NPI-1)
- Name
- Gina Beth Bennett
- Credential
- LPC
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Sep 12, 2010
- Last updated
- Apr 30, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YP2500X | Counselor, Professional | 3593 | OK | Yes |
Practice location
2912 S Douglas BlvdSuite A
Midwest City, OK 73130-7179
Phone 405-698-7399
Mailing address
450 Echo LnHarrah, OK 73045-9654
Phone 405-698-7399
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