| Jason Benton Llc | |
|
1090 Founders Blvd Athens GA 30606-6163 | |
| (706) 549-3606 | |
| Not Available |
| Full Name | Jason Benton Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 1090 Founders Blvd, Athens, Georgia |
| Authorized Official Name and Position | Jason Benton (OWNER/ THERAPIST) |
| Authorized Official Contact | 7065493606 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jason Benton Llc 11425 Nowhere Rd Hull GA 30646-1432 Ph: (706) 549-3606 | Jason Benton Llc 1090 Founders Blvd Athens GA 30606-6163 Ph: (706) 549-3606 |
| NPI Number | 1619458825 |
|---|---|
| Provider Enumeration Date | 08/25/2018 |
| Last Update Date | 08/25/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619458825 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | LPC007064 (Georgia) | Primary |
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