Individual
TEAIRRA BENJAMIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9115 SW OLSEN RD STE 100, PORTLAND, OR 97223-6876
(510) 882-6990
Mailing address
10339 NE PRESCOTT ST APT 304, PORTLAND, OR 97220-3476
(971) 222-7195
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
11/08/2018
Last updated
11/08/2018
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