Provider Demographics
NPI:1902335953
Name:BENNETT, ERICA EHLERS (AUD, PHD)
Entity Type:Individual
Prefix:DR
First Name:ERICA
Middle Name:EHLERS
Last Name:BENNETT
Suffix:
Gender:F
Credentials:AUD, PHD
Other - Prefix:
Other - First Name:ERICA
Other - Middle Name:AUDREY
Other - Last Name:EHLERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:32725 WING LAKE RD
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:MI
Mailing Address - Zip Code:48025-1148
Mailing Address - Country:US
Mailing Address - Phone:313-574-4501
Mailing Address - Fax:
Practice Address - Street 1:2799 W GRAND BLVD # K-8
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48202-2608
Practice Address - Country:US
Practice Address - Phone:313-916-1755
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-05
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1601000765231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist