Individual
KEVIN BENGSCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1800 S LAWE ST, APPLETON, WI 54915-2473
(920) 268-1998
(706) 826-2771
Mailing address
1800 S LAWE ST, APPLETON, WI 54915-2473
(920) 268-1998
(706) 826-2771
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100228123
—
WI
Enumeration date
03/07/2023
Last updated
03/07/2023
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