MEDICARE: MELANIE BENNETT

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
1	225X00000X	Occupational Therapist

General Provider Information

NPI Number	:	1922594357
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELANIE BENNETT

Provider Business Mailing Address
First Line	:	3500 SHEFFIELD MANOR TER
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20904-7262
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3500 SHEFFIELD MANOR TERRACE
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20904
Country	:	US
Telephone Number	:	313-377-8753
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/09/2018
Last Update Date	:	07/09/2018

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Directions to “ MELANIE BENNETT ” Practice Location

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