MEDICARE: KHATYI BENJAMIN

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	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1609708650
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KHATYI BENJAMIN

Provider Business Mailing Address
First Line	:	7295 SMITHFIELD RD
Second Line	:
City	:	MOBILE
State	:	AL
Zip	:	36695-3573
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7856 WESTSIDE PARK DR
Second Line	:
City	:	MOBILE
State	:	AL
Zip	:	36695-8541
Country	:	US
Telephone Number	:	228-313-3106
Fax Number	:

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

Provider Enumeration Date	:	06/02/2026
Last Update Date	:	06/02/2026

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Directions to “ KHATYI BENJAMIN ” Practice Location

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