Benavides, Mary Ann
Benavides, Mary Ann is an individual health care provider with primary practice located at 7425 Maple Terrace , Wauwatosa WI 53213-3154. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Benavides, Mary Ann can be contacted via phone (414) 475-5815.Contact Information
Primary practice address
7425 Maple Terrace
Wauwatosa WI 53213-3154
Phone: (414) 475-5815
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 1319057 | Wisconsin |
Profile Details
| NPI number | 1124087051 |
|---|---|
| LBN Legal business name | Benavides, Mary Ann |
| Credentials | PH D |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 20th, 2006 |
| Last updated | Jul 8th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1124087051 | NPPES |
| Wisconsin | MEDICAID | 39081700 |
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