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Individual

JAIME L BENSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
707 N BROADWAY, BALTIMORE, MD 21205-1832
(443) 923-9200
(443) 923-1895
Mailing address
2931 E BIDDLE ST, BALTIMORE, MD 21213-3939
(443) 923-1886
(443) 923-1875

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
9171
NH
103T00000X
Psychologist
Primary
05236
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
10025287200
ND
01
9171
LICENSE
NE
Enumeration date
07/22/2010
Last updated
10/25/2012
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