Individual
AMANDA BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1539 COUNTRY CLUB RD, FAIRMONT, WV 26554-1306
(304) 366-9100
Mailing address
15 ASHBURY LN, FAIRMONT, WV 26554-3473
(304) 816-7073
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2085
WV
Other
Enumeration date
12/30/2021
Last updated
12/30/2021
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