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MR. STEFAN BENTON MFT

>> Marriage & Family Therapist >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1063645364

Individual Registrant:
MR. STEFAN  BENTON MFT
Gender: M
Sole Proprietor

Location and contact information for practice:
21 TAMAL VISTA BLVD SUITE 224 CORTE MADERA, CA 94925-1130 US
Tel: 415-924-7785  Fax: 415-924-7785

Contact information for business:
21 TAMAL VISTA BLVD SUITE 224 CORTE MADERA, CA 94925-1130 US
Tel: 415-924-7785  Fax: 415-924-7785

Registration Information:
NPI: 1063645364
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y106H00000XBehavioral Health & Social Service Providers
Marriage & Family Therapist
CAMFC34786

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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