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1053897157
TIANA SHARELL BENNETT
SMYRNA, GA
NPI
1053897157
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
235Z00000X Speech-Language Pathologist,
(Licence: GA 14173004)
Enumeration Date
2018-07-12
Last Update Date
2018-07-12
Business Address
TIANA SHARELL BENNETT
1800 LAKE PARK DR SE
SMYRNA, GA 30080-7639
Phone number: 770-438-6928
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Mailing Address
TIANA SHARELL BENNETT
3404 SANDLAKE DR SW
MARIETTA, GA 30008-7638
Phone number: 678-492-4105
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