Individual
KRYSTAL LYNNISE BENJAMIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
B.S.
Contact information
Practice address
2925 RUSSELL ST, DETROIT, MI 48207-4825
(313) 396-5300
Mailing address
175 N GROESBECK HWY, MOUNT CLEMENS, MI 48043-1562
(586) 627-0024
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
6803087084
MI
171M00000X
Case Manager/Care Coordinator
Primary
6803087084
MI
171M00000X
Case Manager/Care Coordinator
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Other
Enumeration date
05/18/2018
Last updated
07/09/2019
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