Provider Demographics
NPI:1013352335
Name:BENSON, STEPHANIE TOLAR (MACCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:TOLAR
Last Name:BENSON
Suffix:
Gender:F
Credentials:MACCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7120 S 91ST ST
Mailing Address - Street 2:APARTMENT 721
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68526-9679
Mailing Address - Country:US
Mailing Address - Phone:402-441-7101
Mailing Address - Fax:
Practice Address - Street 1:7120 S 91ST ST
Practice Address - Street 2:APARTMENT 721
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68526-9679
Practice Address - Country:US
Practice Address - Phone:402-441-7101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-30
Last Update Date:2013-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1537235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist