Provider Demographics
NPI:1346019866
Name:BENNION, TALYA ZOE
Entity Type:Individual
Prefix:
First Name:TALYA
Middle Name:ZOE
Last Name:BENNION
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12687 S ANN CHRISTINE CT
Mailing Address - Street 2:
Mailing Address - City:RIVERTON
Mailing Address - State:UT
Mailing Address - Zip Code:84065-8706
Mailing Address - Country:US
Mailing Address - Phone:610-573-1972
Mailing Address - Fax:801-769-1286
Practice Address - Street 1:111 E MAIN ST STE L4
Practice Address - Street 2:
Practice Address - City:LEHI
Practice Address - State:UT
Practice Address - Zip Code:84043-2490
Practice Address - Country:US
Practice Address - Phone:610-573-1972
Practice Address - Fax:801-769-1286
Is Sole Proprietor?:No
Enumeration Date:2023-12-26
Last Update Date:2023-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife