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Individual

DR. BENJAMIN HUSTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PSYD

Contact information

Practice address
4101 S 4TH ST, LEAVENWORTH, KS 66048-5014
(139) 682-2000
Mailing address
4101 S 4TH ST, LEAVENWORTH, KS 66048-5014
(139) 682-2000

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
103TC0700X
Clinical Psychologist
Primary
PSO1996
RI
390200000X
Student in an Organized Health Care Education/Training Program

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PSO1996
LICENSE NO
RI
Enumeration date
09/27/2015
Last updated
09/20/2021
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