Provider Demographics
NPI:1336760792
Name:BEHENG, KARLA RAE (HIS)
Entity Type:Individual
Prefix:
First Name:KARLA
Middle Name:RAE
Last Name:BEHENG
Suffix:
Gender:F
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4905 MATTERHORN DR
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55811-3851
Mailing Address - Country:US
Mailing Address - Phone:218-723-7880
Mailing Address - Fax:218-723-7880
Practice Address - Street 1:4905 MATTERHORN DR
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55811-3851
Practice Address - Country:US
Practice Address - Phone:218-723-7880
Practice Address - Fax:218-723-8208
Is Sole Proprietor?:No
Enumeration Date:2020-04-27
Last Update Date:2020-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
237700000X
MN2873237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist