Provider Demographics
NPI:1316568421
Name:BENEFIELD, DEBORAH D (MASSAGE THERAPIST)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:D
Last Name:BENEFIELD
Suffix:
Gender:F
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 E ML KING JR DR STE 201
Mailing Address - Street 2:
Mailing Address - City:HINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31313-3650
Mailing Address - Country:US
Mailing Address - Phone:912-332-1596
Mailing Address - Fax:
Practice Address - Street 1:135 E ML KING JR DR STE 201
Practice Address - Street 2:
Practice Address - City:HINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:31313-3650
Practice Address - Country:US
Practice Address - Phone:912-332-1596
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-29
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMT008575225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist