Individual
LUCI RENEE BENETO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2642 W CREEKSTONE CT, MERIDIAN, ID 83646-3843
(208) 901-2880
Mailing address
2642 W CREEKSTONE CT, MERIDIAN, ID 83646-3843
(208) 901-2880
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
193440012
—
ID
Enumeration date
01/03/2020
Last updated
12/19/2025
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