Individual
BENJAMIN RYAN JACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BCBA
Contact information
Practice address
1130 TEN ROD RD STE 201, NORTH KINGSTOWN, RI 02852-4161
(401) 294-3990
Mailing address
1130 TEN ROD RD STE C201, BUILDING C SUITE 201, NORTH KINGSTOWN, RI 02852-4171
(401) 294-3990
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-17-28975
RI
Other
Enumeration date
01/16/2018
Last updated
01/16/2018
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