Maurine Wilcox Bennett, MFS

Individual provider Active NPI Marriage & Family Therapist · Dublin, GA

NPI 1578856092 · NPPES record last updated May 17, 2011

Key facts

NPI
1578856092
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
License
MFT000889 (GA)
Practice address
715 James Currie Rd
Dublin, GA 31021-1489
Phone
(478) 274-0037
Fax
(478) 274-0809
NPI assigned
May 17, 2011
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
MFT000889GAMDMarriage & Family Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFT000889 GA Yes

Addresses

Primary practice location

715 James Currie Rd
Dublin, GA 31021-1489

Mailing address

715 James Currie Rd
Dublin, GA 31021-1489
Phone (478) 274-0037

Other providers in Dublin, GA

All providers in Dublin, GA · Marriage & Family Therapist in Georgia

Sources for this page

Verify at the official NPI Registry.