Healthcare Provider Details

I. General information

NPI: 1619895596
Provider Name (Legal Business Name): ISABELLA RENNE BENITEZ JOYNER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ISABELLA BENITEZ

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3986 HOPE VALLEY DR
WAKE FOREST NC
27587-8519
US

IV. Provider business mailing address

4000 SANCAR WAY STE 410
DURHAM NC
27713-2891
US

V. Phone/Fax

Practice location:
  • Phone: 919-353-8030
  • Fax:
Mailing address:
  • Phone: 919-371-2848
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: