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General NPI Number Information
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NPI Number | 1376984534
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Entity Type | Individual
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Provider Name | BRIANNA CAROLE BENNETTS OTR
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Gender | Female
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Dates
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Enumeration Date | 07/16/2013
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Last Update Date | 01/22/2025
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Provider Practice Location Address
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Address Line | PO BOX 775
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City | BUENA VISTA
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State | CO
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Zip | 81211-0775
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Country | US
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Telephone | 860-605-6420
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 775
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City | BUENA VISTA
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State | CO
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Zip | 81211-0775
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Country | US
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Telephone | 860-605-6420
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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 | 15459
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License Number State | FL
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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 | OT 2752
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License Number State | ME
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Taxonomy #3
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 10963
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License Number State | MA
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Taxonomy #4
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT.0004563
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License Number State | CO
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