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General NPI Number Information
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NPI Number | 1508174756
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Entity Type | Individual
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Provider Name | KIMBERLY BENJAMIN L.P.C,, M.ED., CAC
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Gender | Female
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Dates
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Enumeration Date | 09/22/2010
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Last Update Date | 09/29/2010
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Provider Practice Location Address
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Address Line | 521 PLYMOUTH RD SUITE 106, DOOR F
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City | PLYMOUTH MEETING
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State | PA
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Zip | 19462-1638
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Country | US
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Telephone | 610-265-6464
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Fax |
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Provider Business Mailing Address
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Address Line | 723 ARDMORE AVE
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City | ARDMORE
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State | PA
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Zip | 19003-1835
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Country | US
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Telephone | 610-256-4265
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Fax | 610-645-9474
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 0000095
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License Number State | PA
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