Individual
MR. CODY JAMES BENJAMIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
WAIVER
Contact information
Practice address
69 WILLARD ST, BERLIN, NH 03570-2095
(603) 752-1005
Mailing address
87 WASHINGTON ST, CONWAY, NH 03818-6044
(603) 447-3905
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
08/08/2018
Last updated
08/08/2018
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