Provider Demographics
NPI:1609531086
Name:BENTON, TOBY SARA
Entity Type:Individual
Prefix:
First Name:TOBY
Middle Name:SARA
Last Name:BENTON
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 1:5526 E FRIESS DR
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-2964
Mailing Address - Country:US
Mailing Address - Phone:480-694-6454
Mailing Address - Fax:
Practice Address - Street 1:5526 E FRIESS DR
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-2964
Practice Address - Country:US
Practice Address - Phone:480-694-6454
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-01
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator