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General NPI Number Information
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NPI Number | 1225816085
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Entity Type | Organization
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Legal Business Name | WILDFLOWER SPEECH AND LANGUAGE THERAPY PLLC
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Dates
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Enumeration Date | 09/21/2023
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Last Update Date | 09/21/2023
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Provider Practice Location Address
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Address Line | 2010 HOGBACK RD STE 7A
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City | ANN ARBOR
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State | MI
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Zip | 48105-8800
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Country | US
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Telephone | 248-860-1155
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Fax |
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Provider Business Mailing Address
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Address Line | 213 W MADISON ST
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City | ANN ARBOR
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State | MI
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Zip | 48103-4921
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Country | US
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Telephone | 248-860-1155
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Fax |
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Authorized Official
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Title or Position | SPEECH-LANGUAGE PATHOLOGIST, OWNER
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Name | BETH ANN BENKO
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Credential | MS CCC-SLP
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Telephone | 248-860-1155
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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