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1821796368
BENJAMIN MADDOCK
BLOOMINGTON, IN
NPI
1821796368
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2023-02-22
Last Update Date
2023-02-22
Business Address
BENJAMIN MADDOCK
1117 N JACKSON ST
BLOOMINGTON, IN 47404-3385
Phone number: 812-322-2817
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Mailing Address
BENJAMIN MADDOCK
800 N SMITH RD APT 7B
BLOOMINGTON, IN 47408-2934
Phone number: 812-322-2817
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