Jordan Ethan Benjamin, BA

NPI #1144881129 in Kentwood, Michigan

Provider Information

NPI Number: 1144881129
Entity Type: Individual
Name: Jordan Ethan Benjamin, BA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Credential: BA
Enumeration Date: Jun 21, 2019
Last Updated: Jun 21, 2019

Practice Location

Address: 3361 36TH ST SE
City: Kentwood
State: Michigan
ZIP Code: 49512-2809
Phone: (616) 942-2522

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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