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Individual

TODD A BENSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CDP

Contact information

Practice address
340 NE MAPLE ST, PULLMAN, WA 99163-4120
(509) 334-1133
Mailing address
340 NE MAPLE ST, PULLMAN, WA 99163-4120
(509) 334-1133
(509) 332-1608

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP60081261
WA
104100000X
Social Worker
CG61105894
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
101Y99995L
WA
Enumeration date
06/12/2018
Last updated
09/07/2022
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