Provider Demographics
NPI:1396826319
Name:BENSON, MEG EHLENDT (AT,C, CPED)
Entity Type:Individual
Prefix:MRS
First Name:MEG
Middle Name:EHLENDT
Last Name:BENSON
Suffix:
Gender:F
Credentials:AT,C, CPED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1908 KAREN AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIR
Mailing Address - State:MI
Mailing Address - Zip Code:48079-5562
Mailing Address - Country:US
Mailing Address - Phone:810-326-2972
Mailing Address - Fax:
Practice Address - Street 1:1908 KAREN AVE
Practice Address - Street 2:
Practice Address - City:SAINT CLAIR
Practice Address - State:MI
Practice Address - Zip Code:48079-5562
Practice Address - Country:US
Practice Address - Phone:810-326-2972
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer