| Doctor Name: | MS. TRACEY ANN BENTON |
| NPI Number: | 1639488901 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | L.I.S.W. |
| License Number: | 992261 |
| Business Practice Address: | 416 Xenia Ave Yellow Springs, OH - 453871836 |
| Business Phone Number: | 9377679171 |
| Business Fax Number: | |
| Mailing Address: | 416 Xenia Ave, YELLOW SPRINGS |
| State: | OH |
| Postal Code: | 453871836 |
| Phone Number: | 9377679171 |
| Fax Number: | |
| NPI Enumeration Date: | 10/04/2010 |
| NPI Last Update Date: | 06/18/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 992261 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CO |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |