Individual
LISA BENJAMIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
110 N MITCHELL FORD RD, CLARKTON, NC 28433-9768
(910) 918-1928
Mailing address
110 N MITCHELL FORD RD, CLARKTON, NC 28433-9768
(910) 918-1928
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
4427
NC
Other
Enumeration date
08/19/2014
Last updated
08/19/2014
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