Doctor Name: | TERESA ANN BENJAMIN |
NPI Number: | 1710120886 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMHP, PC |
License Number: | 1702 |
Business Practice Address: | 806 4th Ave Holdrege, NE - 689492205 |
Business Phone Number: | 3089916919 |
Business Fax Number: | |
Mailing Address: | 806 4th Ave, HOLDREGE |
State: | NE |
Postal Code: | 689492205 |
Phone Number: | 3089916919 |
Fax Number: | |
NPI Enumeration Date: | 04/20/2009 |
NPI Last Update Date: | 04/20/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 1702 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NE |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |