Individual
MIA BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3308 TULANE AVE STE 407, NEW ORLEANS, LA 70119-7158
(504) 821-6830
(504) 821-6837
Mailing address
3308 TULANE AVE STE 407, NEW ORLEANS, LA 70119-7158
(504) 821-6830
(504) 821-6837
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2138880
—
LA
Enumeration date
08/14/2017
Last updated
07/21/2022
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