Individual
KIVON SHAVONT'E BENEDICT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1469 JOHNSTON WILLIS DR, NORTH CHESTERFIELD, VA 23235-4730
(804) 477-6393
Mailing address
5404 PONY FARM DR APT D, RICHMOND, VA 23227-3041
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
RBT-19-83340
VA
Other
Enumeration date
01/27/2020
Last updated
01/27/2020
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