Individual
JESSICA BENAVENTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
94-1170 WAIPAHU ST, WAIPAHU, HI 96797-3647
(808) 307-7200
Mailing address
94-521 FARRINGTON HWY, WAIPAHU, HI 96797-3013
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP-1000
HI
Other
Enumeration date
01/08/2019
Last updated
01/08/2019
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