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General NPI Number Information
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NPI Number | 1235606492
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Entity Type | Individual
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Provider Name | BENJAMIN WHITTLE BCBA
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Gender | Male
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Dates
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Enumeration Date | 10/25/2018
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Last Update Date | 12/11/2024
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Provider Practice Location Address
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Address Line | 9607 KINCEY AVE
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City | HUNTERSVILLE
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State | NC
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Zip | 28078-9140
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Country | US
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Telephone | 704-686-7904
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Fax |
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Provider Business Mailing Address
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Address Line | 9607 KINCEY AVE
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City | HUNTERSVILLE
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State | NC
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Zip | 28078-9140
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Country | US
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Telephone | 704-686-7904
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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 | 1-18-32727
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License Number State | CO
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