Provider Demographics
NPI:1871953356
Name:DRAPER, BENJAMIN
Entity type:Individual
Prefix:MR
First Name:BENJAMIN
Middle Name:
Last Name:DRAPER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5097 W CLOUD ST
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-9743
Mailing Address - Country:US
Mailing Address - Phone:785-825-0563
Mailing Address - Fax:
Practice Address - Street 1:5097 W CLOUD ST
Practice Address - Street 2:
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-9743
Practice Address - Country:US
Practice Address - Phone:785-825-0563
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-26
Last Update Date:2016-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS7032104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker