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Individual

PERLA BENAVIDES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2814 WOODCLIFF CIR SE, GRAND RAPIDS, MI 49506-3155
(855) 832-6727
Mailing address
814 ELLIOTT ST SE, GRAND RAPIDS, MI 49507-2724
(616) 666-2063

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
MI
247200000X
Other Technician
Primary
MI

Other

Enumeration date
09/21/2018
Last updated
06/21/2021
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