Individual
JOSEPH BENAVIDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BMS
Contact information
Practice address
707 BROADWAY BLVD NE STE 401, ALBUQUERQUE, NM 87102-2366
(505) 345-8471
Mailing address
707 BROADWAY BLVD NE STE 401, ALBUQUERQUE, NM 87102-2366
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
L7094
—
NM
Enumeration date
09/09/2009
Last updated
01/30/2017
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