Individual
COHLTON BENJAMIN GONSALVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RBT
Contact information
Practice address
1835 PARK AVE, SAN JOSE, CA 95126-1629
(669) 267-6046
Mailing address
949 WILLOWLEAF DR, SAN JOSE, CA 95128-3683
(650) 580-5623
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
07/30/2024
Last updated
07/30/2024
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