Individual
BENETA HELENA TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
356 E GRAND BLVD APT 404, DETROIT, MI 48207-3661
(313) 398-7798
Mailing address
19673 HARNED ST, DETROIT, MI 48234-1508
(313) 398-7798
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
7501007819
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
46-5496216
HEALTH INSURANCE
MI
05
—
46-5496216
—
MI
Enumeration date
09/24/2017
Last updated
09/24/2017
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