Organization
JENNIFER BENTON, PHD, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JENNIFER M BENTON PHD (PSYCHOLOGIST)
(918) 392-4866
Entity
Organization
Contact information
Practice address
4815 S HARVARD AVE, SUITE 470, TULSA, OK 74135-3055
(918) 392-4866
(918) 392-4867
Mailing address
4815 S HARVARD AVE, SUITE 470, TULSA, OK 74135-3055
(918) 392-4866
(918) 392-4867
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1057
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1609927219
INDIVIDUAL NPI# -TYPE I
OK
Enumeration date
11/09/2012
Last updated
11/09/2012
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