Individual
BENJAMIN RENDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1624 CIMARRON PLZ, STILLWATER, OK 74075-3467
(053) 722-2024
(405) 372-2237
Mailing address
1624 CIMARRON PLAZA, STILLWATER, OK 74075-2847
(053) 722-2202
(405) 372-2237
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
104100000X
Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
K081700089
—
OK
Enumeration date
03/29/2011
Last updated
09/23/2021
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