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General NPI Number Information
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NPI Number | 1326497033
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Entity Type | Individual
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Provider Name | WENDY BENNETT
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Gender | Female
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Dates
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Enumeration Date | 06/03/2016
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Last Update Date | 06/03/2016
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Provider Practice Location Address
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Address Line | 20 N PARK AVE SUITE 1300
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City | PLYMOUTH
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State | MA
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Zip | 02360-4090
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Country | US
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Telephone | 508-830-0999
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Fax |
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Provider Business Mailing Address
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Address Line | 64 RIVER ST
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City | PLYMOUTH
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State | MA
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Zip | 02360-2122
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Country | US
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Telephone | 774-454-6321
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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 | 225XP0019X
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Taxonomy Name | Physical Rehabilitation Occupational Therapist
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License Number | 3670
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License Number State | MA
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