Individual
BENJAMIN STANSFIELD FOX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
122 S RUTLEDGE ST, PAULLINA, IA 51046-7822
(763) 528-3110
Mailing address
PO BOX 51, PAULLINA, IA 51046-0051
(763) 528-3110
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT23-262139
IA
Other
Enumeration date
03/06/2023
Last updated
03/06/2023
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