Provider Demographics
NPI:1740457670
Name:BENDA, JENNIFER L (BS)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:L
Last Name:BENDA
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 349
Mailing Address - Street 2:905 MONTGOMERY ST
Mailing Address - City:DECORAH
Mailing Address - State:IA
Mailing Address - Zip Code:52101-0349
Mailing Address - Country:US
Mailing Address - Phone:563-382-3649
Mailing Address - Fax:563-382-8183
Practice Address - Street 1:905 MONTGOMERY ST
Practice Address - Street 2:
Practice Address - City:DECORAH
Practice Address - State:IA
Practice Address - Zip Code:52101-2325
Practice Address - Country:US
Practice Address - Phone:563-382-3649
Practice Address - Fax:563-382-8183
Is Sole Proprietor?:No
Enumeration Date:2008-05-09
Last Update Date:2008-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health