Individual
BENEDETTE THREET
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1650 SPRUCE ST, RIVERSIDE, CA 92507-7402
(760) 815-7772
Mailing address
11357 CHANTRY ST, FONTANA, CA 92337-0872
(909) 915-0922
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
CA
103K00000X
Behavior Analyst
—
—
Other
Enumeration date
08/09/2020
Last updated
10/17/2022
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