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1821611005
TINA BENNETT
CLARKSBURG, WV
NPI
1821611005
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: WV DP00941494)
Enumeration Date
2020-05-22
Last Update Date
2020-05-22
Business Address
TINA BENNETT LICSW
1 MEDICAL CENTER DR
CLARKSBURG, WV 26301
Phone number: 304-623-3461
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Mailing Address
TINA BENNETT LICSW
205 HIGH ST
JANE LEW, WV 26378-7945
Phone number: 304-629-6156
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