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NPI Code Detail

MEDICARE: KELSEY BENTIEN

MEDICARE: KELSEY BENTIEN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational TherapistOTH-010227AZ

General Provider Information

NPI Number : 1477416097
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELSEY BENTIEN
Provider Business Mailing Address
First Line : 1190 E MISSOURI AVE STE 100
Second Line :
City : PHOENIX
State : AZ
Zip : 85014-2719
Country : US
Telephone Number : 602-393-0520
Fax Number :
Provider Business Practice Location Address
First Line : 1190 E MISSOURI AVE STE 100
Second Line :
City : PHOENIX
State : AZ
Zip : 85014-2719
Country : US
Telephone Number : 602-393-0520
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/09/2025
Last Update Date : 12/09/2025

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Directions to “ KELSEY BENTIEN ” Practice Location

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