Individual
MR. JEFFREY TODD BENTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.ED., ED.S.
Contact information
Practice address
200 FOREST GLEN DR, SUFFOLK, VA 23434-6714
(757) 925-6764
Mailing address
100 NORTH MAIN ST PO BOX 1549, SUFFOLK, VA 23434
(757) 925-6764
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
0813000142
VA
Other
Enumeration date
04/24/2019
Last updated
04/24/2019
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