Individual
DEMETRIA BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
403 PARKWAY STE G, GREENSBORO, NC 27401-1653
(336) 549-8660
Mailing address
1101 CAROLINA ST, GREENSBORO, NC 27401-1318
(336) 333-6860
(336) 275-1187
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCAS-22910
NC
101YP2500X
Professional Counselor
—
—
Other
Enumeration date
09/23/2016
Last updated
10/04/2018
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