Most Relevant Information
Provider Data
| NPI Number: | 1003685959 |
| Provider Name: | ELLY BENJAMIN RBT |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: | RBT-23-285526 |
Most Important Dates
| Enumeration Date: | 12/20/2023 |
| Last Updated: | 12/20/2023 |
Provider Practice Location
1353 E MAIN ST
BROWNSBURG
IN
461121433
Practice Location Phone/Fax
| Phone: | 3175204748 |
| Fax: |
Provider Mailing Location
1353 E MAIN ST
BROWNSBURG
IN
461121433
Provider Mailing Phone/Fax
| Phone: | 3175204748 |
| Fax: |