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Individual

BENJAMIN HUME

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
175 W 1400 N, SUITE A, LOGAN, UT 84341-6811
(435) 752-5302
Mailing address
175 W 1400 N, SUITE A, LOGAN, UT 84341-6811
(435) 752-5302

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
253J00000X
Foster Care Agency

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
390200000X
NO INSURANCE, CASH BASIS
UT
Enumeration date
07/26/2012
Last updated
05/23/2013
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