Provider Demographics
NPI:1033258371
Name:BENTHAL, MERIDITH L
Entity Type:Individual
Prefix:
First Name:MERIDITH
Middle Name:L
Last Name:BENTHAL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MERIDITH
Other - Middle Name:L
Other - Last Name:GUEGOLD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:221 DEVONIA ST
Mailing Address - Street 2:
Mailing Address - City:HARRIMAN
Mailing Address - State:TN
Mailing Address - Zip Code:37748-2006
Mailing Address - Country:US
Mailing Address - Phone:865-882-1164
Mailing Address - Fax:865-882-8650
Practice Address - Street 1:221 DEVONIA ST
Practice Address - Street 2:
Practice Address - City:HARRIMAN
Practice Address - State:TN
Practice Address - Zip Code:37748-2006
Practice Address - Country:US
Practice Address - Phone:865-882-1164
Practice Address - Fax:865-882-8650
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator