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General NPI Number Information
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NPI Number | 1225225345
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Entity Type | Individual
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Provider Name | KATHY LEIGH BENNETT OTR/L
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Gender | Female
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Dates
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Enumeration Date | 10/02/2007
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Last Update Date | 08/08/2010
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Provider Practice Location Address
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Address Line | 301 S CHURCH ST SUITE 161
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City | ROCKY MOUNT
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State | NC
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Zip | 27804-5755
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Country | US
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Telephone | 252-212-3909
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Fax | 252-212-3913
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Provider Business Mailing Address
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Address Line | 4816 RIVER FARM RD
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City | ROCKY MOUNT
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State | NC
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Zip | 27803-8300
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Country | US
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Telephone | 252-985-1920
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Fax | 252-985-1920
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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 | 0351
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License Number State | NC
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