Individual
KATINA LYNN BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LLPC
Contact information
Practice address
54710 BATES RD, CHESTERFIELD, MI 48051-1621
(586) 219-2791
Mailing address
54710 BATES RD, CHESTERFIELD, MI 48051-1621
(586) 219-2791
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6401016114
MI
Other
Enumeration date
03/16/2018
Last updated
03/16/2018
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