Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | MH 5684 | FL |
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | ARNP 1128632 | FL |
NPI | 1003097213 |
---|---|
Provider Name | Ms. Clare Denise Benjamin |
First Address | Jacksonville, FL 32223-8667 |
Second Address | Jacksonville, FL 32223-8667 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/11/2007 |
Last Update Date | 22/07/2021 |