Individual
BENJAMIN NOAH GUADALUPE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4134 LINDEN AVE, DAYTON, OH 45432-3043
(937) 365-7455
(937) 600-6071
Mailing address
1628 E DOROTHY LN, KETTERING, OH 45429-3810
(937) 750-8236
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-23-306131
OH
Other
Enumeration date
10/24/2023
Last updated
10/24/2023
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