MEDICARE: STEPHANIE BEHNKE

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
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1043805823
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE BEHNKE

Provider Business Mailing Address
First Line	:	4250 CABRETTA DR SE
Second Line	:
City	:	SMYRNA
State	:	GA
Zip	:	30080-6479
Country	:	US
Telephone Number	:	470-250-0046
Fax Number	:	470-933-4088

Provider Business Practice Location Address
First Line	:	4250 CABRETTA DR SE
Second Line	:
City	:	SMYRNA
State	:	GA
Zip	:	30080-6479
Country	:	US
Telephone Number	:	470-250-0046
Fax Number	:	470-933-4088

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/04/2021
Last Update Date	:	03/11/2026

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Directions to “ STEPHANIE BEHNKE ” Practice Location

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