Individual
DR. BENJAMIN JOSEPH RICHTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
515 NE GLEN OAK AVE, SUITE 101, PEORIA, IL 61637-3167
(309) 655-7378
(309) 655-4609
Mailing address
515 NE GLEN OAK AVE, SUITE 101, PEORIA, IL 61637-3167
(309) 655-7378
(309) 655-4609
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
071.008614
IL
103TC0700X
Clinical Psychologist
4350
AZ
Other
Enumeration date
01/07/2013
Last updated
08/15/2013
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