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Individual

MR. KEVIN LEE BENBOW

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
202 S 1ST AVE STE 104, YUMA, AZ 85364-2366
(928) 750-1774
(928) 783-1065
Mailing address
202 S 1ST AVE STE 104, YUMA, AZ 85364-2366
(928) 750-1774
(928) 783-1065

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LPC 13276
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
LPC13276
ARIZONA BOARD OF BEHAVIORAL HEALTH EXAMINERS
AZ
Enumeration date
01/22/2008
Last updated
03/07/2013
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