Individual
STEPHANIE ALICE BENALLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
PO BOX 315, PINON, AZ 86510-0315
(505) 979-8085
Mailing address
PO BOX 315, PINON, AZ 86510-0315
(505) 979-8085
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
03/27/2025
Last updated
03/27/2025
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