Provider Demographics
NPI:1114136199
Name:BENNETT, GINGER (MT-BC, NMT)
Entity Type:Individual
Prefix:MS
First Name:GINGER
Middle Name:
Last Name:BENNETT
Suffix:
Gender:F
Credentials:MT-BC, NMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:179 SAINT PAUL ST
Mailing Address - Street 2:
Mailing Address - City:BILOXI
Mailing Address - State:MS
Mailing Address - Zip Code:39530-3513
Mailing Address - Country:US
Mailing Address - Phone:228-435-0187
Mailing Address - Fax:228-374-1586
Practice Address - Street 1:179 SAINT PAUL ST
Practice Address - Street 2:
Practice Address - City:BILOXI
Practice Address - State:MS
Practice Address - Zip Code:39530-3513
Practice Address - Country:US
Practice Address - Phone:228-435-0187
Practice Address - Fax:228-374-1586
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist