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General NPI Number Information
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NPI Number | 1083196331
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Entity Type | Individual
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Provider Name | JODI BENATOVICH
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Gender | Female
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Dates
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Enumeration Date | 09/04/2018
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Last Update Date | 02/20/2023
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Provider Practice Location Address
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Address Line | 314 ELLICOTT ST
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City | BATAVIA
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State | NY
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Zip | 14020-3650
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Country | US
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Telephone | 585-815-0247
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Fax |
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Provider Business Mailing Address
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Address Line | 55 DODGE RD
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City | GETZVILLE
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State | NY
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Zip | 14068-1205
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Country | US
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Telephone | 716-831-2700
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 010746
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License Number State | NY
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