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NPI Code Detail

MEDICARE: HANNAH ROSE BENSON MA

MEDICARE:   HANNAH ROSE BENSON  MA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor
2103K00000XBehavior Analyst1-24-77807IN

General Provider Information

NPI Number : 1043046493
Entity Type Code : Individual
Provider Name (Legal Business Name) : HANNAH ROSE BENSON MA
Provider Business Mailing Address
First Line : 127 HEENAN ST
Second Line :
City : CORUNNA
State : IN
Zip : 46730-1006
Country : US
Telephone Number : 630-877-7760
Fax Number :
Provider Business Practice Location Address
First Line : 1400 AIRPORT NORTH OFFICE PARK STE D
Second Line :
City : FORT WAYNE
State : IN
Zip : 46825-6723
Country : US
Telephone Number : 260-702-9141
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/11/2024
Last Update Date : 12/02/2024

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Directions to “ HANNAH ROSE BENSON MA” Practice Location

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