Individual
ELLEN MARIE CARLL-BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
45 BONNEY BRIAR DR, PLYMOUTH, MA 02360-6206
(508) 728-4619
Mailing address
45 BONNEY BRIAR DR, PLYMOUTH, MA 02360-6206
(508) 728-4619
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2187
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
084213
NBCOT
MA
01
—
2187
STATE OF MASSACHUSETTS
MA
01
—
60580357
AOTA
MA
Enumeration date
08/19/2017
Last updated
07/21/2022
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