Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 3594 | KS |
NPI | 1003409830 |
---|---|
Provider Name | Amy Benson |
First Address | Overland Park, KS 66221-2204 |
Second Address | Overland Park, KS 66209-2031 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/02/2021 |
Last Update Date | 12/02/2021 |