Dibenedetto, Michael
Dibenedetto, Michael is an sole proprietor health care provider with primary practice located at 375 Crown Pt , Columbia MO 65203-2202. He recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as his primary health care specialty. Dibenedetto, Michael can be contacted via phone (573) 875-1576.Contact Information
Primary practice address
375 Crown Pt
Columbia MO 65203-2202
Phone: (573) 875-1576
Fax: (573) 449-3171
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | 000222 | Missouri |
Profile Details
| NPI number | 1386620094 |
|---|---|
| LBN Legal business name | Dibenedetto, Michael |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 15th, 2005 |
| Last updated | Jan 31st, 2012 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1386620094 | NPPES |
| Missouri | MEDICAID | 493876015 |
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