Individual
MR. DAN LEWIS BENTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.P.C
Contact information
Practice address
1212 S AIR DEPOT BLVD, 43, MIDWEST CITY, OK 73110-4870
(405) 684-5884
Mailing address
9117 INDIAN CREEK DR, MIDWEST CITY, OK 73130-4265
(405) 684-5884
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
3468
OK
Other
Enumeration date
12/15/2009
Last updated
12/15/2009
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