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DR. JEANNE MARIE BENNETT PSY.D.

Clinical Neuropsychologist

Louisville, Kentucky

Provider NPI: 1164429320

Provider Information:
DR. JEANNE MARIE BENNETT PSY.D.
Gender: F
Not Sole Proprietor

Practice Location:
1169 EASTERN PKWY STE 2238  LOUISVILLE, KY 40217 US
Tel: 502-376-7552  Fax: 502-425-5540

Business Mailing Address:
9012 WILLOW SPRINGS DRIVE  LOUISVILLE, KY 40242 US
Tel: 502-376-7552  Fax: 502-425-5540

Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N103G00000XBehavioral Health & Social Service Providers
Clinical Neuropsychologist
KY1034
N103TC0700XBehavioral Health & Social Service Providers
Psychologist
KY1034
Y103G00000XBehavioral Health & Social Service Providers
Clinical Neuropsychologist
KY129055

Other Provider Identifiers:

IssuerNumberStateType
K197101KY08
ANTHEM000000376778KY01
AETNA7020285KY01
89000061KY05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







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