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General NPI Number Information
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NPI Number | 1245957471
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Entity Type | Organization
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Legal Business Name | BENNINGER & ASSOCIATES
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Dates
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Enumeration Date | 10/27/2022
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Last Update Date | 10/27/2022
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Provider Practice Location Address
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Address Line | 130 NORTHWOODS BLVD STE B
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City | COLUMBUS
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State | OH
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Zip | 43235-7473
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Country | US
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Telephone | 614-233-1761
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Fax |
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Provider Business Mailing Address
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Address Line | 130 NORTHWOODS BLVD STE B
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City | COLUMBUS
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State | OH
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Zip | 43235-7473
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Country | US
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Telephone | 614-233-1761
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Fax |
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Authorized Official
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Title or Position | OWNER/CLINICAL PSYCHOLOGIST
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Name | DR. TARA L BENNINGER
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Credential | PHD
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Telephone | 614-233-1761
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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