Provider Demographics
NPI:1346570447
Name:BENNETT, DAVID K (MS)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:K
Last Name:BENNETT
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 POST RD W
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WESTPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06880-4206
Mailing Address - Country:US
Mailing Address - Phone:203-227-3383
Mailing Address - Fax:203-227-7490
Practice Address - Street 1:120 POST RD W
Practice Address - Street 2:SUITE 102
Practice Address - City:WESTPORT
Practice Address - State:CT
Practice Address - Zip Code:06880-4206
Practice Address - Country:US
Practice Address - Phone:203-227-3383
Practice Address - Fax:203-227-7490
Is Sole Proprietor?:No
Enumeration Date:2010-01-12
Last Update Date:2010-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst