Individual
BRENDOLYNNE BENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11110 BOARDWALK DR APT 11, BATON ROUGE, LA 70816-8393
(225) 235-6848
Mailing address
11110 BOARDWALK DR APT 11, BATON ROUGE, LA 70816-8393
(225) 235-6848
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00000
—
LA
Enumeration date
10/20/2021
Last updated
10/20/2021
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