Individual
MR. BERNARD BENJAMIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
5123 JUAN TABO BLVD NE, ALBUQUERQUE, NM 87111-2672
(505) 292-3333
Mailing address
424 JEFFERSON ST NE, APT 36, ALBUQUERQUE, NM 87108-1289
(772) 318-8113
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
3331
NM
Other
Enumeration date
02/24/2015
Last updated
02/24/2015
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