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KATANDRA BENTON

>> Case Manager/Care Coordinator >> Other Service Providers

Registrant NPI Number: 1023524113

Individual Registrant:
 KATANDRA  BENTON 
Gender: F
Not Sole Proprietor

Location and contact information for practice:
1658 US HIGHWAY 371  PRESCOTT, AR 71857-7064 US
Tel: 870-887-3660  Fax: 870-887-3705

Contact information for business:
2904 ARKANSAS BLVD  TEXARKANA, AR 71854-2536 US
Tel: 870-773-4655  Fax: 870-772-4650

Registration Information:
NPI: 1023524113
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y171M00000XOther Service Providers
Case Manager/Care Coordinator

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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