Leeann Rose Bennett

Individual provider Active NPI Behavior Technician · Port Monmouth, NJ

NPI 1972124709 · NPPES record last updated May 4, 2020

Key facts

NPI
1972124709
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
1 Haven St
Port Monmouth, NJ 07758-1407
Phone
(732) 939-1589
NPI assigned
May 4, 2020
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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician
Group: 193400000X SINGLE SPECIALTY GROUP
106S00000X Yes

Addresses

Primary practice location

1 Haven St
Port Monmouth, NJ 07758-1407

Mailing address

1 Haven St
Port Monmouth, NJ 07758-1407
Phone (732) 939-1589

Other providers in Port Monmouth, NJ

All providers in Port Monmouth, NJ · Behavior Technician in New Jersey

Sources for this page

Verify at the official NPI Registry.