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Individual

CARMEN L BENEDICT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, BCBA

Contact information

Practice address
2542 VT ROUTE, NEWPORT CENTER, VT 05857
(802) 487-9421
Mailing address
124 E PONDEROSA CIR, BRANDON, SD 57005-1900
(810) 434-5334

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
146.0134188
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
146.0134188
BCBA LISENCE
VT
Enumeration date
01/06/2021
Last updated
01/06/2021
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