Susan Marie Bennett, COTA/L

Individual provider Active NPI Occupational Therapy Assistant · Hesston, KS

NPI 1750745352 · NPPES record last updated Apr 9, 2016

Key facts

NPI
1750745352
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
18-00139 (KS)
Practice address
200 W Cedar St
Hesston, KS 67062-8100
Phone
(620) 327-0400
NPI assigned
Apr 9, 2016
Sex
Female
Sole proprietor
Yes

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
18-00139KSMDEnvironmental Modification Occupational Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 18-00139 KS Yes
Environmental Modification Occupational Therapy Assistant 224ZE0001X 18-00139 KS

Addresses

Primary practice location

200 W Cedar St
Hesston, KS 67062-8100

Mailing address

2214 S Estelle St
Wichita, KS 67211-5505
Phone (316) 303-2595

Other providers in Hesston, KS

All providers in Hesston, KS · Occupational Therapy Assistant in Kansas

Sources for this page

Verify at the official NPI Registry.