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Individual

JESSICA BENTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
6196 LAKE GRAY BLVD STE 116, JACKSONVILLE, FL 32244-5867
(800) 356-4049
(941) 485-0519
Mailing address
PO BOX 631278, CINCINNATI, OH 45263-1278
(800) 356-4049
(941) 485-0519

Taxonomy

Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
0-21-12797
FL

Other

Enumeration date
03/10/2021
Last updated
09/22/2021
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