Individual
TRACEY ANDREA ROYSTER-BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3455 WILKENS AVE STE 203, BALTIMORE, MD 21229-5265
(443) 927-5050
Mailing address
414 LIGHT ST UNIT 1301, BALTIMORE, MD 21202-1269
(443) 927-5050
Taxonomy
Speciality
Code
Description
License number
State
103TR0400X
Rehabilitation Psychologist
Primary
—
—
Other
Enumeration date
09/26/2018
Last updated
09/26/2018
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