Provider Demographics
NPI:1053770834
Name:BENFORD, RUTH (MBA)
Entity type:Individual
Prefix:
First Name:RUTH
Middle Name:
Last Name:BENFORD
Suffix:
Gender:F
Credentials:MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11413 BEL AIR PL
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120-7911
Mailing Address - Country:US
Mailing Address - Phone:405-751-1702
Mailing Address - Fax:
Practice Address - Street 1:11413 BEL AIR PL
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-7911
Practice Address - Country:US
Practice Address - Phone:405-751-1702
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-22
Last Update Date:2016-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health