Provider Demographics
NPI:1891892998
Name:BENNETT, TAMIKA MARIE (MS)
Entity Type:Individual
Prefix:MS
First Name:TAMIKA
Middle Name:MARIE
Last Name:BENNETT
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2524 JACQUELINE DR
Mailing Address - Street 2:E-67
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19810-2024
Mailing Address - Country:US
Mailing Address - Phone:215-694-3925
Mailing Address - Fax:
Practice Address - Street 1:2600 W 9TH ST
Practice Address - Street 2:4TH FLOOR, NORTH BUILDING
Practice Address - City:CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19013-2040
Practice Address - Country:US
Practice Address - Phone:610-497-7548
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health