Individual
MR. BENJAMIN LEE PARADISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
802 W 3RD AVE, TOPPENISH, WA 98948-1668
(509) 865-3955
Mailing address
7182 S 1200 E, SOUTH WEBER, UT 84405-9479
(801) 636-8515
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5692129-4202
UT
Other
Enumeration date
10/25/2019
Last updated
10/25/2019
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