Kathleen Benoit

Individual provider Active NPI Day Training/Habilitation Specialist · Wasilla, AK

NPI 1689139461 · NPPES record last updated Feb 5, 2019

Key facts

NPI
1689139461
Entity type
Individual (NPI type 1)
Primary specialty
Day Training/Habilitation Specialist 373H00000X
Practice address
1401 S Seward Meridian Pkwy
Wasilla, AK 99654-8312
Phone
(907) 315-4049
NPI assigned
Feb 5, 2019
Sex
Female
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Day Training/Habilitation Specialist 373H00000X Yes

Addresses

Primary practice location

1401 S Seward Meridian Pkwy
Wasilla, AK 99654-8312

Mailing address

1401 S Seward Meridian Pkwy
Wasilla, AK 99654-8312

Other identifiers

IdentifierTypeStateIssuer
1684068MedicaidAK

Other providers in Wasilla, AK

All providers in Wasilla, AK · Day Training/Habilitation Specialist in Alaska

Sources for this page

Verify at the official NPI Registry.