Bennett, Mavis

Bennett, Mavis is an sole proprietor health care provider with primary practice located at 1100 S Ponce De Leon Blvd Ste 1 , St Augustine FL 32084-6013. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Counseling. Behavioral Health & Social Service Providers / Psychologist is her primary health care specialty. Bennett, Mavis can be contacted via phone (904) 824-7733.

Contact Information

Primary practice address
1100 S Ponce De Leon Blvd Ste 1 St Augustine FL 32084-6013
Phone: (904) 824-7733
Fax: (904) 829-9768
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X MT1268 Florida
Behavioral Health & Social Service Providers / Counseling 103TC1900X MT1268 Florida

Profile Details

NPI number 1003999608
LBN Legal business name Bennett, Mavis
Credentials PSYCHOLOGIST
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 24th, 2006
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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