Individual
BENORA GLADSTONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA,LLP
Contact information
Practice address
6905 TELEGRAPH RD STE 105, BLOOMFIELD HILLS, MI 48301-3177
(248) 594-0487
Mailing address
6905 TELEGRAPH RD STE 105, BLOOMFIELD HILLS, MI 48301-3177
(248) 594-0487
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6361003116
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6361003116
BOARD OF PSYCHOLOGY
MI
Enumeration date
03/16/2023
Last updated
03/16/2023
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