Individual
BENJAMIN MICHAEL HEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1035 STRADER DR STE 150, LEXINGTON, KY 40505-4090
(859) 899-9200
Mailing address
1673 PRAIRIE CIR, LEXINGTON, KY 40515-5373
(270) 844-9107
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
1023793
KY
Other
Enumeration date
11/03/2023
Last updated
11/03/2023
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