Healthcare Provider Details

I. General information

NPI: 1184822124
Provider Name (Legal Business Name): TERRI MARGARET BENNETT OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2007
Last Update Date: 03/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 E HAMPDEN AVE STE 415
ENGLEWOOD CO
80113-2759
US

IV. Provider business mailing address

805 GIGI ST
CASTLE ROCK CO
80104-1615
US

V. Phone/Fax

Practice location:
  • Phone: 303-597-1724
  • Fax: 303-788-5460
Mailing address:
  • Phone: 303-663-1813
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XN1300X
TaxonomyNeurorehabilitation Occupational Therapist
License NumberNBCOT1020341
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: