Individual
BENETTA VINCENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3194 SE TUMBLESTONE DR, HILLSBORO, OR 97123-7966
(678) 548-1122
Mailing address
3194 SE TUMBLESTONE DR, HILLSBORO, OR 97123-7966
(678) 548-1122
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
Other
Enumeration date
06/09/2020
Last updated
06/09/2020
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