| Doctor Name: | JESSICA BENDER |
| NPI Number: | 1932568433 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 17498130 |
| Business Practice Address: | N27w23957 Paul Rd Suite 101 Pewaukee, WI - 530726223 |
| Business Phone Number: | 2622784462 |
| Business Fax Number: | 8153872599 |
| Mailing Address: | 1021 N Mulford Rd, ROCKFORD |
| State: | IL |
| Postal Code: | 611073877 |
| Phone Number: | 8153915600 |
| Fax Number: | 8153164726 |
| NPI Enumeration Date: | 02/12/2016 |
| NPI Last Update Date: | 02/12/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101Y00000X |
| License Number: | 17498130 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | WI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |