Individual
JULIE NICOLE BENJAMIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
204 WHEELER DR, FULTON, MS 38843-8900
(662) 862-3070
(662) 862-4970
Mailing address
PO BOX 188, FULTON, MS 38843-0188
(662) 862-3070
(662) 862-4970
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT1707
MS
Other
Enumeration date
03/12/2007
Last updated
07/08/2007
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