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General NPI Number Information
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NPI Number | 1285138206
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Entity Type | Organization
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Legal Business Name | CONNIE Y BENFIELD PHD PLLC
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Dates
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Enumeration Date | 03/23/2018
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Last Update Date | 09/27/2024
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Provider Practice Location Address
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Address Line | 4601 ANTILLEY RD STE 304
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City | ABILENE
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State | TX
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Zip | 79606-5914
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Country | US
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Telephone | 325-370-8416
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Fax | 325-691-6259
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Provider Business Mailing Address
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Address Line | 534 PROSPERITY RD
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City | ABILENE
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State | TX
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Zip | 79602-5583
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Country | US
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Telephone | 512-426-8710
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Fax | 325-691-6259
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | CONNIE BENFIELD
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Credential |
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Telephone | 512-426-8710
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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 | 23323
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License Number State | TX
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