Individual
MATTHEW BENJAMIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
105 BRIDGE ST # 170, GROTON, CT 06340-3603
(833) 747-4222
Mailing address
72 BORETZ RD, COLCHESTER, CT 06415-1009
(860) 908-3808
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
138069371
CT
Other
Enumeration date
10/10/2025
Last updated
10/10/2025
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