Individual
BONNIE L BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.C.S.W.
Contact information
Practice address
657 CASTLETON AVE, STATEN ISLAND, NY 10301
(718) 448-9775
(718) 448-6072
Mailing address
523 SUMMIT AVE, MAPLEWOOD, NJ 07040-1310
(973) 761-1360
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
R013218
NY
Other
Enumeration date
04/06/2007
Last updated
07/08/2007
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