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Individual

TIFFANY MONIQUE BENNETT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1300 CRESTLINE AVE, CLEVELAND, OH 44109-3081
(216) 334-0312
Mailing address
1300 CRESTLINE AVE APT 419, CLEVELAND, OH 44109-3064

Taxonomy

Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
401666820714
OH
376K00000X
Nurse's Aide

Other

Enumeration date
06/19/2018
Last updated
06/19/2018
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