Individual
KEISTYIUANA BENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
124 FAIRBROOK ST, PINEVILLE, LA 71360-5628
(318) 730-4727
Mailing address
124 FAIRBROOK ST, PINEVILLE, LA 71360-5628
(318) 730-4727
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
03/25/2019
Last updated
10/05/2023
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