MEDICARE: DR. FAITH BENTON PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	6877	MA
2	103TC0700X	Clinical Psychologist	441	NH

General Provider Information

NPI Number	:	1356315816
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FAITH BENTON PH.D.

Provider Business Mailing Address
First Line	:	PO BOX 116
Second Line	:
City	:	ARLINGTON
State	:	MA
Zip	:	02476-0051
Country	:	US
Telephone Number	:	781-648-9202
Fax Number	:

Provider Business Practice Location Address
First Line	:	94 PLEASANT ST
Second Line	:	SUITE 10
City	:	ARLINGTON
State	:	MA
Zip	:	02476-6535
Country	:	US
Telephone Number	:	617-233-8186
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/13/2006
Last Update Date	:	07/08/2007

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Directions to “ DR. FAITH BENTON PH.D.” Practice Location

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