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General NPI Number Information
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NPI Number | 1528824026
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Entity Type | Individual
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Provider Name | STEPHANIE BENJAMIN RBT
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Gender | Female
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Dates
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Enumeration Date | 02/22/2024
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Last Update Date | 03/20/2024
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Provider Practice Location Address
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Address Line | 355 S HIGH ST
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City | WAILUKU
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State | HI
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Zip | 96793-2199
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Country | US
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Telephone | 808-727-5500
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Fax | 808-984-5627
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Provider Business Mailing Address
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Address Line | 1205 ANDUIN AVE
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City | ANTIOCH
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State | TN
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Zip | 37013-4495
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Country | US
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Telephone | 469-487-4075
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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 | 1528824026.
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License Number State |
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