Provider Demographics
NPI:1437706603
Name:BENKERT, BECKY HAAS
Entity Type:Individual
Prefix:
First Name:BECKY
Middle Name:HAAS
Last Name:BENKERT
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 1:43575 BLAKE CREEK RD
Mailing Address - Street 2:
Mailing Address - City:LEONARDTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20650-6047
Mailing Address - Country:US
Mailing Address - Phone:507-401-1296
Mailing Address - Fax:
Practice Address - Street 1:1350 DARES BEACH RD
Practice Address - Street 2:
Practice Address - City:PRINCE FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:20678-4207
Practice Address - Country:US
Practice Address - Phone:443-550-9910
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-22
Last Update Date:2021-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD09153235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist