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Individual
BENJAMIN PRIDEMORE
Active
Individual
BENJAMIN PRIDEMORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-22-240174
FL
Other
Enumeration date
10/19/2022
Last updated
10/19/2022
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