Healthcare Provider Details

I. General information

NPI: 1295911816
Provider Name (Legal Business Name): BETH ANN BENKO M.S. CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BETH ANN SALZ

II. Dates (important events)

Enumeration Date: 01/14/2008
Last Update Date: 06/01/2023
Certification Date: 06/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5060 JACKSON RD STE D
ANN ARBOR MI
48103-1867
US

IV. Provider business mailing address

5706 HAMPSHIRE LN
YPSILANTI MI
48197-3203
US

V. Phone/Fax

Practice location:
  • Phone: 734-627-8001
  • Fax:
Mailing address:
  • Phone: 248-860-1155
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: