Provider Demographics
NPI:1154656874
Name:BENNER, JILL E (AUD)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:E
Last Name:BENNER
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9800B MCKNIGHT RD
Mailing Address - Street 2:SUITE 130
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237-6020
Mailing Address - Country:US
Mailing Address - Phone:412-366-5278
Mailing Address - Fax:412-364-1785
Practice Address - Street 1:9104 BABCOCK BLVD
Practice Address - Street 2:SUITE 3112
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-5818
Practice Address - Country:US
Practice Address - Phone:412-366-3471
Practice Address - Fax:412-348-0150
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-14
Last Update Date:2013-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAT006143231H00000X, 235500000X, 237600000X, 237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No235500000XSpeech, Language and Hearing Service ProvidersSpecialist/Technologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist