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General NPI Number Information
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NPI Number | 1780441394
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Entity Type | Individual
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Provider Name | BRIANNA ALEXIS BENTLEY OTR
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Gender | Female
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Dates
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Enumeration Date | 02/29/2024
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Last Update Date | 02/29/2024
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Provider Practice Location Address
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Address Line | 105 S BLAIR ST
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City | SPRINGDALE
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State | AR
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Zip | 72764-4410
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Country | US
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Telephone | 479-259-2339
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Fax |
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Provider Business Mailing Address
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Address Line | 478 COUNTY ROAD 565
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City | CAULFIELD
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State | MO
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Zip | 65626-7212
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Country | US
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Telephone | 417-372-1046
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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 | OTR3912
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License Number State | AR
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