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NPI Code Detail

MEDICARE: JOANNA ELAINE BENSHOOF BCBA

MEDICARE: JOANNA ELAINE BENSHOOF 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 Analyst1-23-63469GA
2103K00000XBehavior AnalystRBT-20-125294GA

General Provider Information

NPI Number : 1730706623
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOANNA ELAINE BENSHOOF BCBA
Provider Business Mailing Address
First Line : 27777 INKSTER RD STE 100
Second Line :
City : FARMINGTON HILLS
State : MI
Zip : 48334-5312
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 9040 ROSWELL RD STE 500
Second Line :
City : ATLANTA
State : GA
Zip : 30350-1863
Country : US
Telephone Number : 678-978-1094
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/26/2020
Last Update Date : 04/16/2025

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