MEDICARE: MURIEL BENNETT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1134541261
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MURIEL BENNETT

Provider Business Mailing Address
First Line	:	1401 N TAFT ST APT 1419
Second Line	:
City	:	ARLINGTON
State	:	VA
Zip	:	22201-2657
Country	:	US
Telephone Number	:	202-725-0615
Fax Number	:	919-928-5225

Provider Business Practice Location Address
First Line	:	2001 JEFFERSON DAVIS HWY # VA22202
Second Line	:	#211
City	:	ARLINGTON
State	:	VA
Zip	:	22202-3603
Country	:	US
Telephone Number	:	202-725-0615
Fax Number	:	919-928-5225

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/08/2014
Last Update Date	:	01/08/2014

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Directions to “ MURIEL BENNETT ” Practice Location

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