Healthcare Provider Details

I. General information

NPI: 1316888761
Provider Name (Legal Business Name): FOUR CORNERS NEUROPSYCHOLOGY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2026
Last Update Date: 04/01/2026
Certification Date: 04/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7925 PARAGON RD STE 100
DAYTON OH
45459-4092
US

IV. Provider business mailing address

7925 PARAGON RD STE 100
DAYTON OH
45459-4092
US

V. Phone/Fax

Practice location:
  • Phone: 937-251-7990
  • Fax:
Mailing address:
  • Phone: 937-251-7990
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. ERICA BENFIELD
Title or Position: CLINICAL NEUROPSYCHOLOGIST
Credential: PHD
Phone: 937-251-7990