| Doctor Name: | STEPHANIE LYNN BENEDICT |
| NPI Number: | 1316386683 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | IMH10852 |
| Business Practice Address: | 3000 N Atlantic Ave Ste 102 Cocoa Beach, FL - 329315045 |
| Business Phone Number: | 3217845367 |
| Business Fax Number: | |
| Mailing Address: | 163 Riverside Dr, CAPE CANAVERAL |
| State: | FL |
| Postal Code: | 329203746 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 06/20/2013 |
| NPI Last Update Date: | 06/20/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | IMH10852 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |