Individual
JOSE J BENITEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2920 N 4TH ST, FLAGSTAFF, AZ 86004-1816
(928) 522-9400
Mailing address
PO BOX 3630, FLAGSTAFF, AZ 86003-3630
(928) 522-9400
(928) 774-4808
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LAC-13787
AZ
101YP2500X
Professional Counselor
15933
AZ
Other
Enumeration date
04/03/2012
Last updated
03/22/2021
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