Individual
MR. BENJAMIN NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.A., BHT
Contact information
Practice address
4372 E SACK DR, PHOENIX, AZ 85050-3395
(480) 326-4233
Mailing address
4372 E SACK DR, PHOENIX, AZ 85050-3395
(480) 326-4233
Taxonomy
Speciality
Code
Description
License number
State
385HR2055X
Child Mental Illness Respite Care
Primary
3856919
AZ
Other
Enumeration date
07/09/2012
Last updated
07/09/2012
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