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General NPI Number Information
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NPI Number | 1376401232
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Entity Type | Individual
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Provider Name | TIFFANY B BENTON
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Gender | Female
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Dates
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Enumeration Date | 01/12/2026
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Last Update Date | 01/12/2026
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Provider Practice Location Address
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Address Line | 6521 HIGHLAND CREST LN
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City | SACHSE
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State | TX
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Zip | 75048-5550
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Country | US
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Telephone | 469-550-9340
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Fax |
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Provider Business Mailing Address
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Address Line | 119 GREGORY DR
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City | HEATH
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State | TX
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Zip | 75032-8821
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Country | US
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Telephone | 469-550-9340
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | BACB1207639
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License Number State | TX
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