Stacey Marie Bentley, OTR

Individual provider Active NPI Occupational Therapist · Aztec, NM

NPI 1821187642 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1821187642
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
2092 (NM)
Practice address
19 Road 3390
Aztec, NM 87410-9573
Phone
(505) 860-3766
NPI assigned
Oct 12, 2006
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)
Yes

State licenses

LicenseStateTypeSpecialty
2092NMMDChiropractor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 2092 NM Yes

Addresses

Primary practice location

19 Road 3390
Aztec, NM 87410-9573

Mailing address

PO Box 418
Aztec, NM 87410-0418
Phone (505) 860-3766

Other providers in Aztec, NM

All providers in Aztec, NM · Occupational Therapist in New Mexico

Sources for this page

Verify at the official NPI Registry.