Individual
MR. BENEDICT ETIENNE GAUTHIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
645 NE 62ND ST, MIAMI, FL 33138-6234
(626) 604-1966
Mailing address
645 NE 62ND ST, MIAMI, FL 33138-6234
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
IMT4138
FL
Other
Enumeration date
06/28/2024
Last updated
06/28/2024
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