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General NPI Number Information
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NPI Number | 1033629977
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Entity Type | Individual
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Provider Name | MARY HART BENECKE OT
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Gender | Female
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Dates
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Enumeration Date | 10/05/2017
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Last Update Date | 08/22/2025
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Provider Practice Location Address
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Address Line | 1002 WISHARD BLVD
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City | INDIANAPOLIS
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State | IN
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Zip | 46202-4163
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Country | US
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Telephone | 317-944-8868
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Fax | 317-944-6680
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Provider Business Mailing Address
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Address Line | 250 N SHADELAND AVE
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City | INDIANAPOLIS
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State | IN
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Zip | 46219-4959
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Country | US
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Telephone |
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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 | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 8749
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 31007374A
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License Number State | IN
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