Individual
GORDON L. BENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
545 WESTMINSTER ST, FITCHBURG, MA 01420-4727
(978) 342-0685
(975) 342-8495
Mailing address
545 WESTMINSTER ST, FITCHBURG, MA 01420-4727
(978) 342-0685
(975) 342-8495
Taxonomy
Speciality
Code
Description
License number
State
103TH0100X
Health Service Psychologist
Primary
6718
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5
MARRIAGE & FAMILY THERAPY
MA
01
—
6718
PSYCHOLOGY LICD
MD
Enumeration date
03/28/2007
Last updated
07/09/2007
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