| Doctor Name: | BENJAMIN DICKSTEIN |
| NPI Number: | 1174914055 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | 7277 |
| Business Practice Address: | 1000 S Fort Thomas Ave Fort Thomas, KY - 410752305 |
| Business Phone Number: | 5138613100 |
| Business Fax Number: | |
| Mailing Address: | 1000 S Fort Thomas Ave, FORT THOMAS |
| State: | KY |
| Postal Code: | 410752305 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 02/12/2015 |
| NPI Last Update Date: | 02/12/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 7277 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |