Individual
TRACI L BENTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COUNSELING INTERN
Contact information
Practice address
9028 W SAN JUAN AVE, GLENDALE, AZ 85305-2288
(623) 203-3970
Mailing address
9028 W SAN JUAN AVE, GLENDALE, AZ 85305-2288
(623) 203-3970
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
09/05/2024
Last updated
09/05/2024
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