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General NPI Number Information
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NPI Number | 1023748209
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Entity Type | Individual
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Provider Name | CHLOE BETTENCOURT MS, OT
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Gender | Female
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Dates
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Enumeration Date | 06/12/2022
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Last Update Date | 06/12/2022
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Provider Practice Location Address
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Address Line | 85 MAIN ST STE 311
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City | PLYMOUTH
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State | NH
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Zip | 03264-1500
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Country | US
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Telephone | 603-236-6111
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Fax |
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Provider Business Mailing Address
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Address Line | 63 ALLEN FARM RD
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City | NORTHWOOD
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State | NH
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Zip | 03261-3521
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Country | US
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Telephone | 603-560-9339
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 3300
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License Number State | NH
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