Julia Benkert

Individual provider Active NPI Speech-Language Pathologist · Fairborn, OH

NPI 1659775658 · NPPES record last updated Jan 27, 2015

Key facts

NPI
1659775658
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
SP-7196 (OH)
Practice address
900 E Dayton Yellow Springs Rd
Fairborn, OH 45324-3912
Phone
(937) 879-3611
NPI assigned
Oct 20, 2014
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
SP-7196OHMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SP-7196 OH Yes

Addresses

Primary practice location

900 E Dayton Yellow Springs Rd
Fairborn, OH 45324-3912

Mailing address

900 E Dayton Yellow Springs Rd
Fairborn, OH 45324-3912
Phone (937) 879-3611

Other providers in Fairborn, OH

All providers in Fairborn, OH · Speech-Language Pathologist in Ohio

Sources for this page

Verify at the official NPI Registry.