Jackie Lynne Benson, MOT, OTR/L, CLT

Individual provider Active NPI Occupational Therapist · Humboldt, NE

NPI 1003398090 · NPPES record last updated Feb 22, 2021

Key facts

NPI
1003398090
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
2247 (NE)
Practice address
1043 10TH St
Humboldt, NE 68376-6018
Phone
(402) 862-2000
NPI assigned
Sep 5, 2018
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
2247NEMDChiropractor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 2247 NE Yes

Addresses

Primary practice location

1043 10TH St
Humboldt, NE 68376-6018

Mailing address

61740 US Highway 136
Tecumseh, NE 68450-8401
Phone (402) 335-7964

Other practice location 1

1133 N 3rd St
Tecumseh, NE 68450-2069
Phone (402) 335-3357

Other identifiers

IdentifierTypeStateIssuer
2247OtherNEDHHS

Other names

  • Jackie Lynne Straube Former name

Other providers in Humboldt, NE

All providers in Humboldt, NE · Occupational Therapist in Nebraska

Sources for this page

Verify at the official NPI Registry.