| Doctor Name: | BENJAMIN GILDEHAUS |
| NPI Number: | 1144508268 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.A. |
| License Number: | |
| Business Practice Address: | 380 Massachusetts Ave. Acton, MA - 01720 |
| Business Phone Number: | 9782280276 |
| Business Fax Number: | |
| Mailing Address: | 380 Massachusetts Ave., ACTON |
| State: | MA |
| Postal Code: | 01720 |
| Phone Number: | 9782280276 |
| Fax Number: | |
| NPI Enumeration Date: | 07/22/2011 |
| NPI Last Update Date: | 01/18/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |