Individual
AMANDA BENTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2504 CAMINO ENTRADA, SANTA FE, NM 87507-4851
(505) 471-5006
Mailing address
4300 SIERRA BLANCA, SANTA FE, NM 87507-1631
(432) 349-9123
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
247200000X
Other Technician
—
—
Other
Enumeration date
08/02/2016
Last updated
03/20/2017
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