Provider Demographics
NPI:1629177720
Name:HANQUET, BENEDICTE H (PT)
Entity Type:Individual
Prefix:MRS
First Name:BENEDICTE
Middle Name:H
Last Name:HANQUET
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:BENEDICTE
Other - Middle Name:H
Other - Last Name:STAINIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:10435 CLAYTON RD
Mailing Address - Street 2:SUITE 10
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63131-2931
Mailing Address - Country:US
Mailing Address - Phone:314-442-6249
Mailing Address - Fax:314-787-5949
Practice Address - Street 1:10435 CLAYTON RD
Practice Address - Street 2:SUITE 10
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63131-2931
Practice Address - Country:US
Practice Address - Phone:314-442-6249
Practice Address - Fax:314-787-5949
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2010-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070009347225100000X
MO2010032303225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
06032044OtherBC/BS OF ILLINOIS