Individual
DEIJA BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
312 BROOKSIDE AVE, REDLANDS, CA 92373-4608
(909) 805-5077
Mailing address
312 BROOKSIDE AVE, REDLANDS, CA 92373-4608
(909) 805-5077
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
20232
CA
Other
Enumeration date
08/18/2022
Last updated
08/18/2022
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