Provider Demographics
NPI:1114320967
Name:BENARD, DONNA L (MA MFT INTERN)
Entity Type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:L
Last Name:BENARD
Suffix:
Gender:F
Credentials:MA MFT INTERN
Other - Prefix:MISS
Other - First Name:DONNA
Other - Middle Name:L
Other - Last Name:FERGUSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:71 MEEKS POINT RD
Mailing Address - Street 2:
Mailing Address - City:EAST HAMPTON
Mailing Address - State:CT
Mailing Address - Zip Code:06424-1525
Mailing Address - Country:US
Mailing Address - Phone:860-881-6713
Mailing Address - Fax:
Practice Address - Street 1:71 MEEKS POINT RD
Practice Address - Street 2:
Practice Address - City:EAST HAMPTON
Practice Address - State:CT
Practice Address - Zip Code:06424-1525
Practice Address - Country:US
Practice Address - Phone:860-881-6713
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-07
Last Update Date:2014-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist