Individual
JUSTIN RICHARD BENTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
90 SOUTHPORT DR, LEXINGTON, KY 40503-1819
(859) 303-4463
Mailing address
90 SOUTHPORT DR, LEXINGTON, KY 40503-1819
(859) 303-4463
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
285702
KY
Other
Enumeration date
06/15/2021
Last updated
06/08/2023
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