Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 006639 | CT |
NPI | 1003095795 |
---|---|
Provider Name | Scott A Bennett |
First Address | New Haven, CT 06504-8900 |
Second Address | New Haven, CT 06504-8900 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/10/2007 |
Last Update Date | 01/07/2008 |