Healthcare Provider Details

I. General information

NPI: 1215390257
Provider Name (Legal Business Name): KRISTY BENIGNI BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2016
Last Update Date: 03/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1075 WATERDAM PLAZA DR
MC MURRAY PA
15317-2466
US

IV. Provider business mailing address

859 ROLLING ROCK RD
PITTSBURGH PA
15234-2512
US

V. Phone/Fax

Practice location:
  • Phone: 412-760-2512
  • Fax:
Mailing address:
  • Phone: 412-760-2512
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-14-15520
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: