Individual
LATANJULLA BENJAMIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2100 COMER AVE, COLUMBUS, GA 31904-8725
(706) 596-5883
Mailing address
601 BUILDER DR, PHENIX CITY, AL 36869-6418
(706) 566-4951
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
07/18/2008
Last updated
07/18/2008
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