Deon Marquise Bennett
Individual provider Active NPI Behavior Technician · Holt, MI
NPI 1104536713 · NPPES record last updated Dec 5, 2022
Key facts
- NPI
- 1104536713
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 4552 Spahr St
Holt, MI 48842-1122 - Phone
- (517) 884-1882
- NPI assigned
- Dec 5, 2022
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Yes |
Addresses
Primary practice location
4552 Spahr St
Holt, MI 48842-1122
Mailing address
4552 Spahr St
Holt, MI 48842-1122
Other providers in Holt, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 5, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.