Most Relevant Information
Provider Data
| NPI Number: | 1003585654 |
| Provider Name: | BEVERLY BENITO |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/08/2021 |
| Last Updated: | 09/08/2021 |
Provider Practice Location
418 CENTRE ST UNIT C
BOSTON
MA
021305197
Practice Location Phone/Fax
| Phone: | 8002491266 |
| Fax: |
Provider Mailing Location
1301 E ORANGEWOOD AVE
ANAHEIM
CA
928056807
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |