Healthcare Provider Details

I. General information

NPI: 1730203183
Provider Name (Legal Business Name): ALLISON ELIZABETH BEMBE OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/19/2007
Last Update Date: 04/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44 PROSPECT ST APT. 1
RUTLAND VT
05701-5065
US

IV. Provider business mailing address

44 PROSPECT ST APT. 1
RUTLAND VT
05701-5065
US

V. Phone/Fax

Practice location:
  • Phone: 518-791-7036
  • Fax:
Mailing address:
  • Phone: 518-791-7036
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number072-0000438
License Number StateVT
# 2
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number072-0000438
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: