Healthcare Provider Details

I. General information

NPI: 1508707720
Provider Name (Legal Business Name): BENJAMIN BERNIER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2026
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5433 S KILLARNEY ST
CENTENNIAL CO
80015-3665
US

IV. Provider business mailing address

5433 S KILLARNEY ST
CENTENNIAL CO
80015-3665
US

V. Phone/Fax

Practice location:
  • Phone: 303-956-9796
  • Fax:
Mailing address:
  • Phone: 303-956-9796
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: