MARK BARRY BENNETT

IDAHO FALLS, ID
NPI1306273784
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy104100000X Social Worker
(Licence: ID  LMSW-31056)
Enumeration Date2013-10-01
Last Update Date2013-10-01
Business Address
Mr. MARK BARRY BENNETT LMSW
2275 W BROADWAY ST STE G
IDAHO FALLS, ID 83402-2902
Phone number: 208-524-7400
Mailing Address
Mr. MARK BARRY BENNETT LMSW
2275 W BROADWAY ST STE G
IDAHO FALLS, ID 83402-2902
Phone number: 208-524-7400
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