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JESSICA BENNETT LCSW
Clinical >> Social Worker >> Behavioral Health & Social Service ProvidersRegistrant NPI Number: 1902219587
Individual Registrant: JESSICA BENNETT LCSW
Gender: F
Sole Proprietor
Gender: F
Sole Proprietor
Location and contact information for practice:
4613 PARKWAY DR STE 7 TEXARKANA, AR 71854-1191 US
Tel: 870-330-4095 Fax: 844-706-5741
Tel: 870-330-4095 Fax: 844-706-5741
Contact information for business:
4613 PARKWAY DR STE 7 TEXARKANA, AR 71854-1191 US
Tel: 870-330-4095 Fax: 844-706-5741
Tel: 870-330-4095 Fax: 844-706-5741
Registration Information:
NPI: 1902219587
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 1041C0700X | Behavioral Health & Social Service Providers Social Worker Clinical |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| 202688795 | AR | 05 |
