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NPI Code Detail

MEDICARE: TIFFANY BENFIELD BCBA

MEDICARE: TIFFANY BENFIELD BCBA
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
1103K00000XBehavior Analyst1-18-29378OH

General Provider Information

NPI Number : 1083119895
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIFFANY BENFIELD BCBA
Provider Business Mailing Address
First Line : 2430 VAN BUREN AVE
Second Line :
City : SPRINGFIELD
State : OH
Zip : 45505-2555
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2430 VAN BUREN AVE
Second Line :
City : SPRINGFIELD
State : OH
Zip : 45505-2555
Country : US
Telephone Number : 303-989-8169
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/26/2018
Last Update Date : 03/16/2023

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