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Individual

DAAIMAH JENNELL BENNETT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
702 N 10TH ST, PHILADELPHIA, PA 19123-1959
(267) 584-2322
Mailing address
702 N 10TH ST, PHILADELPHIA, PA 19123-1959
(267) 584-2322

Taxonomy

Speciality
Code
Description
License number
State
174200000X
Meals Provider
PA
332U00000X
Home Delivered Meals
PA
343900000X
Non-emergency Medical Transport (VAN)
Primary

Other

Enumeration date
02/11/2021
Last updated
09/14/2021
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