Provider Demographics
NPI:1295965754
Name:BENO, BETH (MS/CF-SLP)
Entity type:Individual
Prefix:MRS
First Name:BETH
Middle Name:
Last Name:BENO
Suffix:
Gender:F
Credentials:MS/CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9632 W APPLETON AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53225-3305
Mailing Address - Country:US
Mailing Address - Phone:414-535-6704
Mailing Address - Fax:414-535-6952
Practice Address - Street 1:9632 W APPLETON AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53225-3305
Practice Address - Country:US
Practice Address - Phone:414-535-6704
Practice Address - Fax:414-535-6952
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-19
Last Update Date:2009-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3228-154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist