Individual
TIARA BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2995 E GRAND BLVD, DETROIT, MI 48202-3133
(313) 758-0255
Mailing address
2660 JOHN R ST, DETROIT, MI 48201-3177
(313) 758-0255
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
11/03/2021
Last updated
11/03/2021
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