Individual
MYRA LYN BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPT
Contact information
Practice address
5350 POPLAR AVE STE 730, MEMPHIS, TN 38119-3697
(901) 683-5658
(901) 684-1277
Mailing address
5350 POPLAR AVE STE 730, MEMPHIS, TN 38119-3697
(901) 683-5658
(901) 684-1277
Taxonomy
Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
Primary
0022
TN
Other
Enumeration date
04/17/2007
Last updated
07/08/2007
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