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NPI Code Detail

MEDICARE: SYNETRA BENSON

MEDICARE:   SYNETRA  BENSON
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
1106S00000XBehavior Technician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1679039473
Entity Type Code : Individual
Provider Name (Legal Business Name) : SYNETRA BENSON
Provider Business Mailing Address
First Line : 8527 FRANKLIN COVE WAY
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46239-2261
Country : US
Telephone Number : 317-746-4971
Fax Number :
Provider Business Practice Location Address
First Line : 8527 FRANKLIN COVE WAY
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46239-2261
Country : US
Telephone Number : 317-746-4971
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/16/2019
Last Update Date : 02/16/2019

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Directions to “ SYNETRA BENSON ” Practice Location

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