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1952431793
LISAH NICHOLE BENNETT
SOUTH PASADENA, CA
NPI
1952431793
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225400000X Rehabilitation Practitioner
(Licence: CA IMF 46200)
Enumeration Date
2007-03-07
Last Update Date
2007-07-13
Business Address
-- LISAH NICHOLE BENNETT MS MFT
625 S. FAIR OAKS BLVD #300
SOUTH PASADENA, CA 91030
Phone number: 626-831-2509
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Mailing Address
-- LISAH NICHOLE BENNETT MS MFT
625 S. FAIR OAKS AVE. STE. 300
S. PASADENA, CA 91030
Phone number:
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