Individual
BENITA LASHAE PRIESTLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1069 BROADWAY AVE STE 201, SEASIDE, CA 93955-4995
(831) 383-3562
Mailing address
1069 BROADWAY AVE STE 201, SEASIDE, CA 93955-4995
(831) 383-3562
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
LCS20974
CA
Other
Enumeration date
08/01/2024
Last updated
08/01/2024
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