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General NPI Number Information
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NPI Number | 1730053372
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Entity Type | Individual
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Provider Name | KATRINA BENTLEY
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Gender | Female
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Dates
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Enumeration Date | 10/04/2025
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Last Update Date | 10/04/2025
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Provider Practice Location Address
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Address Line | 1089 COUNTY ROAD 55
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City | NOTASULGA
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State | AL
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Zip | 36866-3244
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Country | US
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Telephone | 334-759-9289
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 46
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City | NOTASULGA
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State | AL
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Zip | 36866-0046
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Country | US
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Telephone |
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6444C
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License Number State | AL
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