Individual
EVA MARIE BENINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
615 RUSSELL AVE, WALSENBURG, CO 81089-2127
(719) 738-2076
Mailing address
615 RUSSELL AVE, WALSENBURG, CO 81089-2127
(719) 738-2076
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LPCC.0021073
CO
Other
Enumeration date
09/12/2023
Last updated
09/12/2023
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