Individual
BENJAMIN T BENCOMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LISW
Contact information
Practice address
47 ALAMEDA RD, LAS VEGAS, NM 87701-3996
(505) 454-9738
(505) 425-9285
Mailing address
47 ALAMEDA RD, LAS VEGAS, NM 87701-3996
(505) 454-9738
(505) 425-9285
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I-07690
NM
Other
Enumeration date
08/16/2011
Last updated
08/16/2011
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