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General NPI Number Information
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NPI Number | 1699912600
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Entity Type | Individual
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Provider Name | JENNIFER MARIE BENNETT OTR/L
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Gender | Female
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Dates
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Enumeration Date | 01/13/2009
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Last Update Date | 10/19/2009
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Provider Practice Location Address
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Address Line | 3800 RESERVOIR RD NW BLES G-12
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City | WASHINGTON
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State | DC
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Zip | 20007-2113
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Country | US
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Telephone | 202-444-3562
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Fax |
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Provider Business Mailing Address
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Address Line | 3800 RESERVOIR RD NW BLES G-12
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City | WASHINGTON
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State | DC
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Zip | 20007-2113
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Country | US
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Telephone | 202-444-3562
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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 | 4278
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License Number State | AZ
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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 | OT010000577
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License Number State | DC
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