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Individual

ISMERAI BENITEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CG60662276

Contact information

Practice address
918 E. MEAD AVE., YAKIMA, WA 98903
(509) 453-1344
(509) 453-2981
Mailing address
918 E MEAD AVE, YAKIMA, WA 98903-3720
(509) 453-1344
(509) 453-2981

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
CG60662276
WA
175T00000X
Peer Specialist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
CG60662276
WA
Enumeration date
07/20/2016
Last updated
01/28/2019
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