Individual
JACQUIS BENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MHPP
Contact information
Practice address
634 W MAIN ST, BLYTHEVILLE, AR 72315-3336
(870) 780-6986
(870) 780-6987
Mailing address
634 W MAIN ST, BLYTHEVILLE, AR 72315-3336
(870) 780-6986
(870) 780-6987
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
03/20/2013
Last updated
03/20/2013
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