Individual
TONYA S BENZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6369 GOOSE LAKE DR, COMPLIANCE MAIL CODE-2433, VERONA, WI 53593-9255
(608) 848-1632
Mailing address
6369 GOOSE LAKE DR, COMPLIANCE MAIL CODE-2433, VERONA, WI 53593-9255
(608) 848-1632
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3877-26
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3877-26
OT
WI
Enumeration date
07/24/2006
Last updated
07/08/2007
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