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Individual

JACKIE LYNNE BENSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MOT, OTR/L, CLT

Contact information

Practice address
1043 10TH ST, HUMBOLDT, NE 68376-6018
(402) 862-2000
Mailing address
61740 US HIGHWAY 136, TECUMSEH, NE 68450-8401
(402) 335-7964

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2247
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2247
DHHS
NE
Enumeration date
09/05/2018
Last updated
02/22/2021
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