Individual
REBECCA BENTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3080 W 3RD ST, ELK CITY, OK 73644-4323
(580) 225-5136
Mailing address
3080 W 3RD ST, ELK CITY, OK 73644-4323
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
02/07/2012
Last updated
02/07/2012
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