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General NPI Number Information
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NPI Number | 1073690475
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Entity Type | Individual
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Provider Name | GEORGE EDWARD BENNETT JR. MA, MAMS
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Gender | Male
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 06/26/2008
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Provider Practice Location Address
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Address Line | 129 CHARLES ST
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City | HANOVER
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State | PA
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Zip | 17331-1807
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Country | US
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Telephone | 717-633-1227
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Fax |
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Provider Business Mailing Address
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Address Line | 665 HERRS RIDGE RD
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City | GETTYSBURG
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State | PA
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Zip | 17325-8451
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Country | US
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Telephone | 717-337-2695
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 016190
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | PC004454
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License Number State | PA
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