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NPI Code Detail

MEDICARE: MISS MEGAN MARIE BENNETT-O'BRIEN

MEDICARE: MISS MEGAN MARIE BENNETT-O'BRIEN
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
1104100000XSocial Worker

General Provider Information

NPI Number : 1972513216
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS MEGAN MARIE BENNETT-O'BRIEN
Provider Business Mailing Address
First Line : 1024 SUPERIOR ST
Second Line :
City : PORT HURON
State : MI
Zip : 48060-3748
Country : US
Telephone Number : 810-966-0099
Fax Number : 810-696-7339
Provider Business Practice Location Address
First Line : 1024 SUPERIOR ST
Second Line :
City : PORT HURON
State : MI
Zip : 48060-3748
Country : US
Telephone Number : 810-966-0099
Fax Number : 810-696-7339
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/09/2006
Last Update Date : 09/24/2020

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Directions to “ MISS MEGAN MARIE BENNETT-O'BRIEN ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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