Provider Demographics
NPI:1346691474
Name:BEHNKE, STEFANIE
Entity Type:Individual
Prefix:DR
First Name:STEFANIE
Middle Name:
Last Name:BEHNKE
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 1:243 E HURON AVE STE A
Mailing Address - Street 2:
Mailing Address - City:BAD AXE
Mailing Address - State:MI
Mailing Address - Zip Code:48413-1351
Mailing Address - Country:US
Mailing Address - Phone:989-553-3277
Mailing Address - Fax:989-474-3277
Practice Address - Street 1:243 E HURON AVE STE A
Practice Address - Street 2:
Practice Address - City:BAD AXE
Practice Address - State:MI
Practice Address - Zip Code:48413-1351
Practice Address - Country:US
Practice Address - Phone:989-553-3277
Practice Address - Fax:989-474-3277
Is Sole Proprietor?:No
Enumeration Date:2016-06-30
Last Update Date:2021-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1601000741231H00000X, 237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI904396202Medicaid
MI0H24439OtherBCBS
MI904396202Medicaid