Provider Demographics
NPI:1740912468
Name:BENSON, ELIZABETH DAWN (AUD)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:DAWN
Last Name:BENSON
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:429 W 69TH ST
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57108-3824
Mailing Address - Country:US
Mailing Address - Phone:605-306-5756
Mailing Address - Fax:605-306-5676
Practice Address - Street 1:429 W 69TH ST
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57108-3824
Practice Address - Country:US
Practice Address - Phone:605-306-5756
Practice Address - Fax:605-306-5676
Is Sole Proprietor?:No
Enumeration Date:2022-06-30
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD1083-A231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD1083-AOtherSD STATE AUD LICENSE