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Individual

MS. KIM A BENSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA CCC-A

Contact information

Practice address
100C STROUD BUILDING RT. 611, STROUDSBURG, PA 18360-9064
(570) 421-6112
(570) 421-7066
Mailing address
STROUD BUILDING RT. 611 SUITE 100C, STROUDSBURG, PA 18360
(570) 421-6112
(570) 421-7066

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
AT001039L
PA
237600000X
Audiologist-Hearing Aid Fitter
AT001039L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1007412000003
PA
01
2736797
AETNA HMO PA
PA
01
3531596
AETNA HMO NJ
PA
01
4899809
GHI
PA
01
7263015
AETNA TRADITIONAL NJ & PA
PA
01
814334
FIRST PRIORITY
PA
01
98857
LOCAL 825
PA
01
BE1375023
BLUE CROSS BLUE SHEILD
PA
Enumeration date
07/03/2007
Last updated
04/15/2008
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