Benjamin Lane Richey, RBT

Individual provider Active NPI Behavior Technician · Port Wentworth, GA

NPI 1477060705 · NPPES record last updated Jan 9, 2018

Key facts

NPI
1477060705
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
License
RBT-17-1870-74439
Practice address
204 Turnberry St
Port Wentworth, GA 31407-1925
Phone
(912) 247-7749
Fax
(912) 247-7749
NPI assigned
Jan 9, 2018
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-17-1870-74439 Yes

Addresses

Primary practice location

204 Turnberry St
Port Wentworth, GA 31407-1925

Mailing address

204 Turnberry St
Port Wentworth, GA 31407-1925
Phone (912) 247-7749

Other providers in Port Wentworth, GA

All providers in Port Wentworth, GA · Behavior Technician in Georgia

Sources for this page

Verify at the official NPI Registry.