Provider Demographics
NPI:1366747909
Name:DELANEY, BENJAMIN BLYE
Entity type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:BLYE
Last Name:DELANEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2943 RIVERSIDE DR
Mailing Address - Street 2:SUITES D-E
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24541-3436
Mailing Address - Country:US
Mailing Address - Phone:186-679-9773
Mailing Address - Fax:143-479-9773
Practice Address - Street 1:2943 RIVERSIDE DR
Practice Address - Street 2:SUITES D-E
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24541-3436
Practice Address - Country:US
Practice Address - Phone:186-679-9773
Practice Address - Fax:143-479-9773
Is Sole Proprietor?:No
Enumeration Date:2011-01-12
Last Update Date:2011-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202005832235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist