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General NPI Number Information
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NPI Number | 1164045795
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Entity Type | Individual
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Provider Name | BENJAMIN CRAIG
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Gender | Male
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Dates
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Enumeration Date | 05/18/2020
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Last Update Date | 02/03/2025
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Provider Practice Location Address
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Address Line | 56 ADELBERT ST
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City | BEREA
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State | OH
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Zip | 44017-1702
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Country | US
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Telephone | 440-568-7373
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Fax |
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Provider Business Mailing Address
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Address Line | 4322 W 49TH ST
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City | CLEVELAND
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State | OH
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Zip | 44144-1952
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Country | US
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Telephone | 440-732-8551
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-24-70912
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License Number State | OH
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