Individual
CAMERON D BENIDT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
220 BROADWAY, FORT EDWARD, NY 12828-1502
(518) 338-3482
(518) 334-3484
Mailing address
11 WINGS FALLS CT, QUEENSBURY, NY 12804-9137
(518) 788-7083
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
001473
NY
Other
Enumeration date
02/19/2019
Last updated
02/19/2019
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