Individual
BENJAMIN LOGAN RASH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4440 VIKING DR, BOSSIER CITY, LA 71111-7511
(318) 588-8908
(318) 588-8909
Mailing address
PO BOX 1823, WEST MONROE, LA 71294-1823
(318) 588-8908
(318) 588-8909
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RBT-21-180711
BACB -REGISTERED BEHAVIOR TECHNICIAN CERTIFICATION
—
Enumeration date
08/25/2021
Last updated
08/25/2021
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