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General NPI Number Information
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NPI Number | 1588109698
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Entity Type | Individual
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Provider Name | RILEY BENJUMEN PATE L.P.C.,L.M.F.T.
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Gender | Male
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Dates
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Enumeration Date | 12/28/2016
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Last Update Date | 01/29/2020
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Provider Practice Location Address
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Address Line | 905 MCAFEE MEDICAL CIRCLE
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City | BEEBE
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State | AR
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Zip | 72012
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Country | US
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Telephone | 501-232-2600
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Fax | 501-242-0820
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Provider Business Mailing Address
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Address Line | 905 MCAFEE MEDICAL CIRCLE
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City | BEEBE
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State | AR
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Zip | 72012
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Country | US
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Telephone | 501-232-2600
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Fax | 501-242-0820
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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