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General NPI Number Information
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NPI Number | 1356871719
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Entity Type | Individual
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Provider Name | JOANNA BENDER OTR/L
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Gender | Female
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Dates
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Enumeration Date | 06/18/2017
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Last Update Date | 03/14/2019
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Provider Practice Location Address
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Address Line | 88 CLARK LN
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City | WATERFORD
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State | CT
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Zip | 06385-2118
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Country | US
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Telephone | 860-235-3726
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Fax |
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Provider Business Mailing Address
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Address Line | 10106 MAPLE TREE LN
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City | EAST LYME
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State | CT
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Zip | 06333-1680
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Country | US
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Telephone | 508-353-5300
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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 | 004455
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License Number State | CT
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