Individual
MRS. AUTUMN SAGE BENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7289 WILSON ST, DURANT, OK 74701-0817
(814) 483-1212
Mailing address
7289 WILSON ST, DURANT, OK 74701-0817
(814) 483-1212
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
DX7962
MD
133N00000X
Nutritionist
Primary
—
—
171400000X
Health & Wellness Coach
—
—
Other
Enumeration date
04/13/2021
Last updated
02/03/2026
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