Individual
BENJAMIN DORAN LEMMON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1626 S VON ELM ST APT 2, POCATELLO, ID 83201-2457
(208) 220-2552
Mailing address
1626 S VON ELM ST APT 2, POCATELLO, ID 83201-2457
(208) 220-2552
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
ID
Other
Enumeration date
06/26/2020
Last updated
06/26/2020
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