Individual
DAMIEN BENTLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
10611 NW SR 20, BRISTOL, FL 32321
(850) 447-4546
(850) 643-5066
Mailing address
348 W MULBERRY ST, MOULTRIE, GA 31768-2523
(229) 798-5242
(850) 643-5066
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
ISW13093
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ISW13093
STATE OF FLORIDA DOH
FL
Enumeration date
12/12/2019
Last updated
12/12/2019
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