Individual
MS. CHRISTAN LATONYA BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
1589 MOUNTAIN LAKE DR E, JACKSONVILLE, FL 32221-5548
(904) 337-9073
(904) 337-4448
Mailing address
1589 MOUNTAIN LAKE DR E, JACKSONVILLE, FL 32221-5548
(904) 337-9073
(904) 337-4448
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
160994624
FL
1041C0700X
Clinical Social Worker
Primary
SW13712
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
029573621
—
FL
Enumeration date
02/01/2013
Last updated
11/24/2024
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