Mary Jane Darnell, COTA

Individual provider Active NPI Occupational Therapy Assistant · Benton, KY

NPI 1447419031 · NPPES record last updated Jun 9, 2008

Key facts

NPI
1447419031
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
KY-A3613 (KY)
Practice address
2607 Main Street
Benton, KY 42025
Phone
(270) 527-0147
NPI assigned
Jun 9, 2008
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)
No

State licenses

LicenseStateTypeSpecialty
057.002750ILMDOccupational Therapy Assistant
KY-A3613KYMDOccupational Therapy Assistant
2006019734MOMDOccupational Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X KY-A3613 KY Yes
Occupational Therapy Assistant 224Z00000X 057.002750 IL
Occupational Therapy Assistant 224Z00000X 2006019734 MO

Addresses

Primary practice location

2607 Main Street
Benton, KY 42025

Mailing address

2607 Main Street
Benton, KY 42025

Other providers in Benton, KY

All providers in Benton, KY · Occupational Therapy Assistant in Kentucky

Sources for this page

Verify at the official NPI Registry.