Individual
CHARLES SAMUEL BENTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8200 GEORGIA ST, MERRILLVILLE, IN 46410-6227
(219) 791-1400
(219) 791-1422
Mailing address
8200 GEORGIA ST, MERRILLVILLE, IN 46410-6227
(219) 791-1400
(219) 791-1422
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
02/22/2011
Last updated
01/11/2012
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