Individual
MRS. TINA BENSON
Active
Individual
MRS. TINA BENSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
—
—
372600000X
Adult Companion
—
—
3747P1801X
Personal Care Attendant
Primary
19-012089-1
IN
376J00000X
Homemaker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200937350A
—
IN
Enumeration date
09/25/2019
Last updated
04/07/2020
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