Provider Demographics
NPI:1508609090
Name:BEHNKEN, MARIAME (STNA)
Entity type:Individual
Prefix:
First Name:MARIAME
Middle Name:
Last Name:BEHNKEN
Suffix:
Gender:F
Credentials:STNA
Other - Prefix:
Other - First Name:MARIAME
Other - Middle Name:
Other - Last Name:SYLLA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:STNA
Mailing Address - Street 1:7016 HUBBARD DR
Mailing Address - Street 2:
Mailing Address - City:HUBER HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:45424-3420
Mailing Address - Country:US
Mailing Address - Phone:240-413-3752
Mailing Address - Fax:
Practice Address - Street 1:7016 HUBBARD DR
Practice Address - Street 2:
Practice Address - City:HUBER HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:45424-3420
Practice Address - Country:US
Practice Address - Phone:240-413-3752
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-13
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH322052801219251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health