MEDICARE: BRANWYNNE MAY BENNION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor

General Provider Information

NPI Number	:	1467664961
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRANWYNNE MAY BENNION

Provider Business Mailing Address
First Line	:	7339 GRANT RANCH BLVD #232
Second Line	:
City	:	LITTLETON
State	:	CO
Zip	:	80123
Country	:	US
Telephone Number	:	720-981-5852
Fax Number	:

Provider Business Practice Location Address
First Line	:	4141 E DICKENSON PL
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80222
Country	:	US
Telephone Number	:	303-504-6500
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/04/2007
Last Update Date	:	07/08/2007

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