Provider Demographics
NPI:1750682522
Name:BENAVIDES, CHRISTIAN AUGUSTO (PHD, BCBA-D)
Entity Type:Individual
Prefix:DR
First Name:CHRISTIAN
Middle Name:AUGUSTO
Last Name:BENAVIDES
Suffix:
Gender:M
Credentials:PHD, BCBA-D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 ARTHUR DR
Mailing Address - Street 2:
Mailing Address - City:WHITINSVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:01588-1935
Mailing Address - Country:US
Mailing Address - Phone:508-902-8271
Mailing Address - Fax:
Practice Address - Street 1:42 ARTHUR DR
Practice Address - Street 2:
Practice Address - City:WHITINSVILLE
Practice Address - State:MA
Practice Address - Zip Code:01588-1935
Practice Address - Country:US
Practice Address - Phone:508-902-8271
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-10
Last Update Date:2021-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst