Individual
MR. COLLINS BENYE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
11633 HAWTHORNE BLVD, 210, HAWTHORNE, CA 90250-2321
(310) 978-0461
Mailing address
1951 S SHERBOURNE DR APT 3, LOS ANGELES, CA 90034-1342
(310) 815-8846
Taxonomy
Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
Primary
RI-B0509271001
CA
Other
Enumeration date
05/10/2007
Last updated
07/08/2007
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