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Individual

BENJAMIN LANE RICHEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RBT

Contact information

Practice address
204 TURNBERRY ST, PORT WENTWORTH, GA 31407-1925
(912) 247-7749
(912) 247-7749
Mailing address
204 TURNBERRY ST, PORT WENTWORTH, GA 31407-1925
(912) 247-7749
(912) 247-7749

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-17-1870-74439

Other

Enumeration date
01/09/2018
Last updated
01/09/2018
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