Individual
MR. DIEGO BENITEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
10000 N 31ST AVE STE B109, PHOENIX, AZ 85051-9586
(480) 597-7321
Mailing address
10000 N 31ST AVE STE B109, PHOENIX, AZ 85051-9586
(480) 597-7321
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000000
OTHER
—
Enumeration date
05/21/2022
Last updated
05/21/2022
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