Provider Demographics
NPI:1043805823
Name:BEHNKE, STEPHANIE
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:BEHNKE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3131 LAWRENCEVILLE SUWANEE RD STE A3
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-7488
Mailing Address - Country:US
Mailing Address - Phone:470-589-1878
Mailing Address - Fax:470-870-1771
Practice Address - Street 1:3131 LAWRENCEVILLE SUWANEE RD STE A3
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-7488
Practice Address - Country:US
Practice Address - Phone:470-589-1878
Practice Address - Fax:470-870-1771
Is Sole Proprietor?:No
Enumeration Date:2021-03-04
Last Update Date:2022-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst