Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | NBCOT1020341 | MD |
NPI | 1184822124 |
---|---|
Provider Name | Terri Margaret Bennett |
First Address | Castle Rock, CO 80104-1615 |
Second Address | Englewood, CO 80113-2759 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2007 |
Last Update Date | 21/03/2008 |