Individual
MRS. STACEY DIANE BENJAMIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
450 LAKE HAVASU AVE S UNIT 202, LAKE HAVASU CITY, AZ 86403-4504
(928) 863-7078
Mailing address
3520 BUCKBOARD WAY, LAKE HAVASU CITY, AZ 86404-3449
(928) 208-8410
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
05/28/2025
Last updated
05/28/2025
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