| Doctor Name: | JESSIE ANGELINE BENHAM |
| NPI Number: | 1184878159 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PHD |
| License Number: | 92-10P |
| Business Practice Address: | 1311 Fort Street Ste. J Barling, AR - 72923 |
| Business Phone Number: | 4794525040 |
| Business Fax Number: | |
| Mailing Address: | Po Box 23047, BARLING |
| State: | AR |
| Postal Code: | 729230047 |
| Phone Number: | 4794525040 |
| Fax Number: | |
| NPI Enumeration Date: | 11/04/2008 |
| NPI Last Update Date: | 11/04/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 92-10P |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AR |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |