Individual
MR. BENJAMIN EDWARD PROBST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
20 W FAIRMOUNT AVE, LAKEWOOD, NY 14750-1702
(716) 338-0033
Mailing address
7082 LIGHT RD, WESTFIELD, NY 14787-9781
(716) 338-0033
(716) 338-1575
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
72 078938
NY
Other
Enumeration date
10/09/2014
Last updated
10/09/2014
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