Provider Demographics
NPI:1508183070
Name:BENITEZ, MONICA LYZETTE (MS,CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:LYZETTE
Last Name:BENITEZ
Suffix:
Gender:F
Credentials:MS,CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 801
Mailing Address - Street 2:
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577-1616
Mailing Address - Country:US
Mailing Address - Phone:210-885-5181
Mailing Address - Fax:
Practice Address - Street 1:8961 TESORO DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78217-6209
Practice Address - Country:US
Practice Address - Phone:210-407-0000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-23
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX110463235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist