Provider Demographics
NPI:1801980693
Name:BENN-BURTON, WINNETHA SHERIDENA (PHD)
Entity type:Individual
Prefix:MRS
First Name:WINNETHA
Middle Name:SHERIDENA
Last Name:BENN-BURTON
Suffix:
Gender:F
Credentials:PHD
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Mailing Address - Street 1:2215 FULLER RD # 116B
Mailing Address - Street 2:VA ANN ARBOR HEALTHCARE SYSTEM
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105-2335
Mailing Address - Country:US
Mailing Address - Phone:734-769-7100
Mailing Address - Fax:734-213-6934
Practice Address - Street 1:2215 FULLER RD # 116B
Practice Address - Street 2:VA ANN ARBOR HEALTHCARE SYSTEM
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48105-2335
Practice Address - Country:US
Practice Address - Phone:734-769-7100
Practice Address - Fax:734-213-6934
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI6301006999103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical