Individual
BENEDICTA BANNERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
39201 STATE ST, FREMONT, CA 94538-1437
(866) 206-2008
Mailing address
39201 STATE ST, FREMONT, CA 94538-1437
(866) 206-2008
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
106S00000X
Behavior Technician
—
—
225100000X
Physical Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
09/08/2020
Last updated
09/08/2020
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