Individual
JENNA BENEVENTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2035 W ILES AVE, SPRINGFIELD, IL 62704-4192
(815) 858-0032
Mailing address
2035 W ILES AVE, SPRINGFIELD, IL 62704-4192
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
B51543200863
IL
Other
Enumeration date
05/27/2025
Last updated
05/27/2025
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