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Individual

ZURISADAI BENITEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
3901 AIRPORT FWY, #230, BEDFORD, TX 76021
(817) 354-5200
Mailing address
3901 AIRPORT FWY STE 230, BEDFORD, TX 76021-6091

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
74022
TX
101YP2500X
Professional Counselor
74022
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
74022
LICENSED PROFESSIONAL COUNSELOR
TX
Enumeration date
06/08/2017
Last updated
06/08/2017
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