Individual
DR. DIANNE BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
5850 TG LEE BLVD, ORLANDO, FL 32822
(407) 375-4179
Mailing address
5850 T G LEE BLVD STE 400, ORLANDO, FL 32822-4409
(917) 379-0032
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
55454
XX
FL
Enumeration date
04/12/2021
Last updated
04/12/2021
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