MEDICARE: BETH ANN BENKO M.S. CCC-SLP

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	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1295911816
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BETH ANN BENKO M.S. CCC-SLP

Provider Business Mailing Address
First Line	:	5706 HAMPSHIRE LN
Second Line	:
City	:	YPSILANTI
State	:	MI
Zip	:	48197-3203
Country	:	US
Telephone Number	:	248-860-1155
Fax Number	:

Provider Business Practice Location Address
First Line	:	5060 JACKSON RD STE D
Second Line	:
City	:	ANN ARBOR
State	:	MI
Zip	:	48103-1867
Country	:	US
Telephone Number	:	734-627-8001
Fax Number	:

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

Provider Enumeration Date	:	01/14/2008
Last Update Date	:	06/01/2023

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Directions to “ BETH ANN BENKO M.S. CCC-SLP” Practice Location

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