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1114536018
SAMUEL RICHARD BENNETT
CHICAGO, IL
NPI
1114536018
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2020-07-27
Last Update Date
2020-07-27
Business Address
SAMUEL RICHARD BENNETT
5214 N WESTERN AVE
CHICAGO, IL 60625-2589
Phone number: 773-250-1769
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Mailing Address
SAMUEL RICHARD BENNETT
1465 LAKE DR
MORRIS, IL 60450-2405
Phone number: 815-207-3975
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