Individual
BENNETT SAMUELS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
4094 LAFAYETTE ST, MARIANNA, FL 32446-5648
(850) 482-7441
(850) 914-8261
Mailing address
525 E 15TH ST, PANAMA CITY, FL 32405-5412
(850) 522-4485
(850) 914-6281
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW 0003879
FL
Other
Enumeration date
11/16/2005
Last updated
07/08/2007
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