Provider Demographics
NPI:1346742459
Name:BENNING, KAIGAN
Entity type:Individual
Prefix:MRS
First Name:KAIGAN
Middle Name:
Last Name:BENNING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KAIGAN
Other - Middle Name:
Other - Last Name:LOERA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8229 BOONE BLVD STE 660
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-2657
Mailing Address - Country:US
Mailing Address - Phone:703-821-1363
Mailing Address - Fax:
Practice Address - Street 1:8229 BOONE BLVD STE 660
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22182-2657
Practice Address - Country:US
Practice Address - Phone:703-821-1363
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-05
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician