Individual
DEJORIS BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2392 EDGEWOOD AVE N, JACKSONVILLE, FL 32254-1725
(904) 485-2128
Mailing address
2392 EDGEWOOD AVE N, JACKSONVILLE, FL 32254-1725
(904) 485-2128
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
373H00000X
Day Training/Habilitation Specialist
—
—
Other
Enumeration date
07/08/2025
Last updated
07/15/2025
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