Provider Demographics
NPI:1134541261
Name:BENNETT, MURIEL
Entity type:Individual
Prefix:
First Name:MURIEL
Middle Name:
Last Name:BENNETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 N TAFT ST APT 1419
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22201-2657
Mailing Address - Country:US
Mailing Address - Phone:202-725-0615
Mailing Address - Fax:919-928-5225
Practice Address - Street 1:2001 JEFFERSON DAVIS HWY # VA22202
Practice Address - Street 2:#211
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22202-3603
Practice Address - Country:US
Practice Address - Phone:202-725-0615
Practice Address - Fax:919-928-5225
Is Sole Proprietor?:No
Enumeration Date:2014-01-08
Last Update Date:2014-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health