MEDICARE: VICTORIA BENENATI MS CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	08437	MD

General Provider Information

NPI Number	:	1922580265
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VICTORIA BENENATI MS CCC-SLP

Provider Business Mailing Address
First Line	:	1438 STEUART ST
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21230-5363
Country	:	US
Telephone Number	:	908-397-9195
Fax Number	:

Provider Business Practice Location Address
First Line	:	1438 STEUART ST
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21230-5363
Country	:	US
Telephone Number	:	908-397-9195
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/04/2018
Last Update Date	:	09/30/2021

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