MEDICARE: DR. CHERYL A BENSON-BLANKENSHIP

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	103TC1900X	Counseling Psychologist	5520	OH

General Provider Information

NPI Number	:	1942275185
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHERYL A BENSON-BLANKENSHIP

Provider Business Mailing Address
First Line	:	2800 MARKET AVE N STE 14
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44714-1779
Country	:	US
Telephone Number	:	330-497-1798
Fax Number	:	330-497-1322

Provider Business Practice Location Address
First Line	:	2800 MARKET AVE N STE 14
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44714-1779
Country	:	US
Telephone Number	:	330-497-1798
Fax Number	:	330-497-1322

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

Provider Enumeration Date	:	02/21/2006
Last Update Date	:	02/25/2015

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