Most Relevant Information
Provider Data
| NPI Number: | 1003529033 |
| Provider Name: | MARIAH LYNN BENNETT |
| Entity Type: | Individual |
| Taxonomy Code: | 101YP2500X |
| Specialty: | Counselor |
| License Number: | LPCC.0017180 |
Most Important Dates
| Enumeration Date: | 01/04/2023 |
| Last Updated: | 01/04/2023 |
Provider Practice Location
5475 MARK DABLING BLVD STE 100
COLORADO SPRINGS
CO
809183847
Practice Location Phone/Fax
| Phone: | 8552847483 |
| Fax: | 6178070958 |
Provider Mailing Location
PO BOX 748465
ATLANTA
GA
303748465
Provider Mailing Phone/Fax
| Phone: | 8552847483 |
| Fax: | 6178070958 |