Individual
MS. LAURA LEE BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA., LLP
Contact information
Practice address
1007 PARCHMENT DR SE, GRAND RAPIDS, MI 49546-3664
(616) 690-0434
Mailing address
1007 PARCHMENT DR SE, GRAND RAPIDS, MI 49546-3664
(616) 690-0434
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
Primary
6301011875
MI
Other
Enumeration date
08/06/2007
Last updated
08/06/2007
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