Provider Demographics
NPI:1477906071
Name:BENNETT, RACHEL DENISE (MA)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:DENISE
Last Name:BENNETT
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3455 BUCKHART CREEK RD
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:IN
Mailing Address - Zip Code:46131-9102
Mailing Address - Country:US
Mailing Address - Phone:317-319-2188
Mailing Address - Fax:
Practice Address - Street 1:3455 BUCKHART CREEK RD
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:IN
Practice Address - Zip Code:46131-9102
Practice Address - Country:US
Practice Address - Phone:317-319-2188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-19
Last Update Date:2016-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health