Evy Jo Benjamin
Individual provider Active NPI Behavior Technician · Kennett, MO
NPI 1992405005 · NPPES record last updated Mar 7, 2023
Key facts
- NPI
- 1992405005
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 1109 Jones St
Kennett, MO 63857-3824 - Phone
- (573) 888-5925
- NPI assigned
- Mar 7, 2023
- Sex
- Female
- Sole proprietor
- No
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Yes |
Addresses
Primary practice location
1109 Jones St
Kennett, MO 63857-3824
Mailing address
1109 Jones St
Kennett, MO 63857-3824
Phone (573) 888-5925
Other providers in Kennett, MO
- Berley Beck
- Jeffrey Tyler Beck
- Melinda Gaye Becknell
- Erin Jon Bedwell
- Christina L Bellers
- Devante S Bennett
- Donna Marie Bennett
- Beverly Ann Berry
- Angela Marie Bevill
- Elizabeth Biggs
All providers in Kennett, MO · Behavior Technician in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 7, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.