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Individual

LISA BENTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
2403 W BEN WHITE BLVD, AUSTIN, TX 78704-7534
(512) 707-2782
(512) 707-2783
Mailing address
5701 S MO PAC EXPY APT 134, AUSTIN, TX 78749-1434
(512) 442-7578

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
35488
TX

Other

Enumeration date
08/23/2006
Last updated
07/08/2007
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