Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst |
NPI | 1003363805 |
---|---|
Provider Name | Laturra Benson |
First Address | Stuart, FL 34997-7462 |
Second Address | Detroit, MI 48243-1502 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/09/2016 |
Last Update Date | 07/02/2022 |