Provider Demographics
NPI:1720329774
Name:BENNETT, MONIQUE (MSW)
Entity Type:Individual
Prefix:MS
First Name:MONIQUE
Middle Name:
Last Name:BENNETT
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5749 WESTGATE DR
Mailing Address - Street 2:102
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32835-5039
Mailing Address - Country:US
Mailing Address - Phone:407-803-2382
Mailing Address - Fax:
Practice Address - Street 1:5749 WESTGATE DR
Practice Address - Street 2:102
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32835-5039
Practice Address - Country:US
Practice Address - Phone:407-803-2382
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-14
Last Update Date:2013-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical