Provider Demographics
NPI:1770735359
Name:BENEDETTO, MARY CATHERINE (DIPLAC, (NCCAOM))
Entity type:Individual
Prefix:MS
First Name:MARY
Middle Name:CATHERINE
Last Name:BENEDETTO
Suffix:
Gender:F
Credentials:DIPLAC, (NCCAOM)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 SILVER BLUFF RD
Mailing Address - Street 2:
Mailing Address - City:AIKEN
Mailing Address - State:SC
Mailing Address - Zip Code:29803-7327
Mailing Address - Country:US
Mailing Address - Phone:803-649-4047
Mailing Address - Fax:803-649-4048
Practice Address - Street 1:224 SILVER BLUFF RD
Practice Address - Street 2:
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29803-7327
Practice Address - Country:US
Practice Address - Phone:803-649-4047
Practice Address - Fax:803-649-4048
Is Sole Proprietor?:No
Enumeration Date:2008-10-15
Last Update Date:2008-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC52171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist